Healthcare Provider Details

I. General information

NPI: 1528645686
Provider Name (Legal Business Name): TRINA KAYEUM CAPELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4440 W 95TH ST # 1126M
OAK LAWN IL
60453-2600
US

IV. Provider business mailing address

4440 W 95TH ST # 1126M
OAK LAWN IL
60453-2600
US

V. Phone/Fax

Practice location:
  • Phone: 708-684-8000
  • Fax: 708-499-0948
Mailing address:
  • Phone: 708-684-8000
  • Fax: 708-499-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036.178706
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: