Provider Demographics
NPI:1306845011
Name:CAPLEA, GEOFFREY O (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:O
Last Name:CAPLEA
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:PO BOX 699
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-0699
Mailing Address - Country:US
Mailing Address - Phone:708-647-9800
Mailing Address - Fax:708-647-9814
Practice Address - Street 1:19624 GOVERNORS HWY
Practice Address - Street 2:SUITE 9
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-2077
Practice Address - Country:US
Practice Address - Phone:708-647-9800
Practice Address - Fax:708-647-9814
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036106422207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL20-3954071OtherTAX ID #
IL036106422Medicaid
IL080192230Medicare ID - Type UnspecifiedRAILROAD MEDICARE NUMBER
ILH76747Medicare UPIN
IL20-3954071OtherTAX ID #
ILL99716Medicare PIN