Provider Demographics
NPI:1447489448
Name:CABALLERO, NADIESKA
Entity type:Individual
Prefix:
First Name:NADIESKA
Middle Name:
Last Name:CABALLERO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 HIGGINS RD STE 325
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5740
Mailing Address - Country:US
Mailing Address - Phone:847-287-2078
Mailing Address - Fax:847-655-7450
Practice Address - Street 1:1030 HIGGINS RD STE 325
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5740
Practice Address - Country:US
Practice Address - Phone:847-287-2078
Practice Address - Fax:847-655-7450
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036138417207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology