Provider Demographics
NPI:1083679146
Name:CHAPEL, KEVIN M (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:CHAPEL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4113 HUMBERT RD
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-7116
Mailing Address - Country:US
Mailing Address - Phone:618-465-7777
Mailing Address - Fax:618-465-7787
Practice Address - Street 1:4113 HUMBERT RD
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-7116
Practice Address - Country:US
Practice Address - Phone:618-465-7777
Practice Address - Fax:618-465-7787
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice