# CAPODICE, EFAW, OCHELTREE & ELGER PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CAPODICE, EFAW, OCHELTREE & ELGER PLLC
- **Other names:** Drs Doran Capodice Efaw & Ocheltree LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1710985759
- **Legal business name:** CAPODICE, EFAW, OCHELTREE & ELGER PLLC
- **Authorized official:** MRS. KYNDRA BATA (OFFICE MANAGER)
- **Authorized official phone:** (309) 663-2526

## Contact information

- **Practice address:** 109 N REGENCY DR, BLOOMINGTON, IL 61701-3515
- **Practice address phone:** (309) 663-2526
- **Practice address fax:** (309) 663-4788
- **Mailing address:** 109 N REGENCY DR, BLOOMINGTON, IL 61701-3515
- **Mailing address phone:** (309) 663-2526
- **Mailing address fax:** (309) 663-4788

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | NULL | — |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | — | — | — |

## Other

- **Enumeration date:** 07/13/2005
- **Last updated:** 12/20/2023