Provider Demographics
NPI:1568787539
Name:CAPULLI, RACHAL PAGE (PA-C)
Entity Type:Individual
Prefix:
First Name:RACHAL
Middle Name:PAGE
Last Name:CAPULLI
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2001 BUTTERFIELD RD
Mailing Address - Street 2:STE 300
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1069
Mailing Address - Country:US
Mailing Address - Phone:630-725-2700
Mailing Address - Fax:
Practice Address - Street 1:3341 UNICORN LAKE BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0102
Practice Address - Country:US
Practice Address - Phone:469-800-1400
Practice Address - Fax:469-800-1401
Is Sole Proprietor?:No
Enumeration Date:2010-04-02
Last Update Date:2019-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA06594363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX441061YKTPMedicare UPIN