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Dr. Jack Capodice JR.

Oral and Maxillofacial Pathology

109 N Regency Dr
Bloomington , Illinois 61701-3515

Write a Review Save Call QR Code

(309) 663-4788

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Dr. Jack Capodice JR.

Oral and Maxillofacial Pathology

109 N Regency Dr
Bloomington , Illinois 61701-3515

(309) 663-4788

Write a Review Save Call

Dr. Jack Capodice JR.

Oral and Maxillofacial Pathology

109 N Regency Dr
Bloomington , Illinois 61701-3515

(309) 663-4788 Call

Write a Review Save
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Location
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Dr. Jack Capodice JR.
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About

Features

Language(s) Spoken
English
Ethnic Identity
White / Caucasian

Specialties

  • Oral and Maxillofacial Pathology

Languages spoken

  • English

Location

109 N Regency Dr Bloomington , Illinois 61701-3515
Get Directions

First Address

  • Dr. Jack Capodice JR.
  • 109 N Regency Dr
  • Bloomington, IL
  • Zip : 61701-3515
  • Fax : (309) 663-4788
  • Phone : (309) 663-2526

Second Address

  • Dr. Jack Capodice JR.
  • 109 N Regency Dr
  • Bloomington, IL
  • Zip : 61701-3515
  • Fax : (309) 663-4788
  • Phone : (309) 663-2526

Reviews

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FAQs

Where did Dr. Jack Capodice JR. attend graduate school?

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Where did Dr. Jack Capodice JR. do his residency?

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Where did Dr. Jack Capodice JR. do his fellowship?

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Is Dr. Jack Capodice JR. board certified?

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What type of doctor is Dr. Jack Capodice JR.

Oral and Maxillofacial Pathology

In what state does Dr. Jack Capodice JR. practice in?

Illinois

Where is Dr. Jack Capodice JR.’s practice located?

109 N Regency Dr , Bloomington, Illinois, 61701-3515

What is Dr. Jack Capodice JR.’s gender?

Male

Is Dr. Jack Capodice JR. a sole practitioner?

No

Is Dr. Jack Capodice JR. accepting new patients?

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What languages does Dr. Jack Capodice JR. speak?

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Does Dr. Jack Capodice JR. accept insurance?

Yes, Dr. Jack Capodice JR. accepts insurance

Does Dr. Jack Capodice JR. offers telemedicine?

Dr. Jack Capodice JR. has not indicated if he offers telemedicine

What is Dr. Jack Capodice JR.’s professional license number?

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What is Dr. Jack Capodice JR.’s NPI number?

1053397612

Does Dr. Jack Capodice JR. have any license restrictions?

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Scope of Practice

Primary Taxonomy Code Taxonomy Specialty License Number License State
Y 1223P0106X Oral and Maxillofacial Pathology 019022744 IL

National Provider Identifier

NPI 1053397612
Provider Name Dr. Jack Capodice JR.
First Address Bloomington, IL 61701-3515
Second Address Bloomington, IL 61701-3515
Gender M
NPI Entity type Individual
Is Sole Proprietor No
Is Organization Subpart N/A
Enumeration Date 15/12/2005
Last Update Date 01/07/2019

Additional Identifiers

IDENTIFIER TYPE / CODE IDENTIFIER STATE
BC0670174 DEA (01) IL
F40908 (02) IL

NPI Footnotes

What is the National Provider Identifier (NPI)

The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address

The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address

The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code

The code describing the type of health care provider that is being assigned an NPI. The entity type codes are:
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?

Subparts are the components and separate physical locations of organization health care providers. Subpart examples include: Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name

The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.

Provider Enumeration Date

The date the provider was assigned a unique identifier (assigned an NPI)

Last Update Date

The date that a NPI record was last updated or changed

Primary Taxonomy Code

The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPls the license data is associated to the taxonomy code.

Authorized Official Name

The name of the person authorized to submit the PI application or to officially change data for a health care provider.

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