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Individual

KENT S KAPITAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
751 N RUTLEDGE ST, RM 0300, SPRINGFIELD, IL 62702-4968
(217) 545-5864
(217) 545-4734
Mailing address
PO BOX 19636, SPRINGFIELD, IL 62794-9636
(217) 545-0187
(217) 788-5543

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
036112857
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036112857
IL
Enumeration date
10/06/2005
Last updated
07/22/2010
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