Provider Demographics
NPI:1497023824
Name:KAPIDIS, ANDIOPI (DT)
Entity Type:Individual
Prefix:MISS
First Name:ANDIOPI
Middle Name:
Last Name:KAPIDIS
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 MALLARD LNDG
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-3066
Mailing Address - Country:US
Mailing Address - Phone:708-289-6007
Mailing Address - Fax:
Practice Address - Street 1:269 MALLARD LNDG
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-3066
Practice Address - Country:US
Practice Address - Phone:708-289-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist