Provider Demographics
NPI:1467507822
Name:KAPPER PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:KAPPER PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KAPPER
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:815-786-1888
Mailing Address - Street 1:523 E. RAILROAD ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-2286
Mailing Address - Country:US
Mailing Address - Phone:815-786-1888
Mailing Address - Fax:815-786-1811
Practice Address - Street 1:523 E. RAILROAD ST.
Practice Address - Street 2:SUITE A
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-2286
Practice Address - Country:US
Practice Address - Phone:815-786-1888
Practice Address - Fax:815-786-1811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL04732009OtherBCBS GROUP NUMBER
ILDD07077OtherMEDICARE RAILROAD GROUP
IL04732009OtherBCBS GROUP NUMBER