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ERIC LEE KAPUSTKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
1775 W DEMPSTER ST, PARK RIDGE, IL 60068-1143
(847) 723-2210
Mailing address
255 W MICHIGAN AVE, PO BOX 1123, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036-088345
IL

Other

Enumeration date
06/09/2006
Last updated
09/25/2024
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