Provider Demographics
NPI:1225105281
Name:CAPOBIANCO, FRANK (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:CAPOBIANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7046 W HIGGINS
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656
Mailing Address - Country:US
Mailing Address - Phone:773-763-0260
Mailing Address - Fax:773-763-8499
Practice Address - Street 1:7046 W HIGGINS
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656
Practice Address - Country:US
Practice Address - Phone:773-763-0260
Practice Address - Fax:773-763-8499
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2015-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069932207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL510217097Medicaid
IL510217097Medicaid
C44158Medicare UPIN