Provider Demographics
NPI:1992970826
Name:CABRAL, BRIAN MICHAEL ICASAS (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN MICHAEL
Middle Name:ICASAS
Last Name:CABRAL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:710 N FAIRBANKS CT
Mailing Address - Street 2:OLSON 4-500
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-3013
Mailing Address - Country:US
Mailing Address - Phone:312-926-4880
Mailing Address - Fax:312-926-4885
Practice Address - Street 1:710 N FAIRBANKS CT
Practice Address - Street 2:OLSON 4-500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3013
Practice Address - Country:US
Practice Address - Phone:312-926-4880
Practice Address - Fax:312-926-4885
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036116418207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology