Provider Demographics
NPI:1952302465
Name:KAPICKA, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:KAPICKA
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 1:25233 NETWORK PLACE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-1252
Mailing Address - Country:US
Mailing Address - Phone:630-390-1240
Mailing Address - Fax:630-390-1247
Practice Address - Street 1:1538 N. ARLINGTON HEIGHTS ROAD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-3906
Practice Address - Country:US
Practice Address - Phone:847-253-6464
Practice Address - Fax:847-253-6501
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036069747174400000X
IL036-069747207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC39425Medicare UPIN