Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 36109573 | IL |
NPI | 1154321222 |
---|---|
Provider Name | Dr. Piero Capecci |
First Address | Springfield, IL 62794-9248 |
Second Address | Springfield, IL 62702-3719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 21/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
36109573 | (05) | IL |
H58916 | (02) | IL |