Provider Demographics
NPI:1912105735
Name:PAUL J. CAPRIOTTI, M.D.,S.C.
Entity Type:Organization
Organization Name:PAUL J. CAPRIOTTI, M.D.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CAPRIOTTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-357-4608
Mailing Address - Street 1:3033 OGDEN AVE
Mailing Address - Street 2:STE. 210
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-1673
Mailing Address - Country:US
Mailing Address - Phone:630-357-4608
Mailing Address - Fax:
Practice Address - Street 1:3033 OGDEN AVE
Practice Address - Street 2:STE. 210
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-1673
Practice Address - Country:US
Practice Address - Phone:630-357-4608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
209503Medicare ID - Type Unspecified