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NPI Code Detail

MEDICARE: DR. QUINN CAPERS IV M.D.

MEDICARE: DR. QUINN CAPERS IV M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician036.177453IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053312413
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. QUINN CAPERS IV M.D.
Provider Business Mailing Address
First Line : 1725 W HARRISON ST STE 1159
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3883
Country : US
Telephone Number : 312-942-5020
Fax Number :
Provider Business Practice Location Address
First Line : 1725 W HARRISON ST STE 1159
Second Line :
City : CHICAGO
State : IL
Zip : 60612-3883
Country : US
Telephone Number : 312-942-5020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 10/08/2025

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