Provider Demographics
NPI:1912120981
Name:CHAPKO, JAMES RUDOLPH (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RUDOLPH
Last Name:CHAPKO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 678
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:IL
Mailing Address - Zip Code:61008
Mailing Address - Country:US
Mailing Address - Phone:815-544-5144
Mailing Address - Fax:815-544-5161
Practice Address - Street 1:140 N STATE ST
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:IL
Practice Address - Zip Code:61008-3518
Practice Address - Country:US
Practice Address - Phone:815-544-5144
Practice Address - Fax:815-544-5161
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist