Healthcare Provider Details

I. General information

NPI: 1831496322
Provider Name (Legal Business Name): CAPITAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7107 W BELMONT AVE SUITE 8
CHICAGO IL
60634-4688
US

IV. Provider business mailing address

613 GREENDALE RD
GLENVIEW IL
60025-3907
US

V. Phone/Fax

Practice location:
  • Phone: 773-814-2506
  • Fax: 773-622-3016
Mailing address:
  • Phone: 773-814-2506
  • Fax: 773-622-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number036100281
License Number StateIL

VIII. Authorized Official

Name: DR. PAUL NASILOWSKI
Title or Position: PRESIDENT
Credential: MD
Phone: 773-814-2506