Healthcare Provider Details

I. General information

NPI: 1952175994
Provider Name (Legal Business Name): JUSTIN KAPELINSKI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2023
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 FREEDOM DR STE 101
NAPERVILLE IL
60563-5707
US

IV. Provider business mailing address

1811 FREEDOM DR STE 101
NAPERVILLE IL
60563-5707
US

V. Phone/Fax

Practice location:
  • Phone: 877-999-1500
  • Fax: 888-866-4702
Mailing address:
  • Phone: 877-999-1500
  • Fax: 888-866-4702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number209028256
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number209-028256
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: