Healthcare Provider Details

I. General information

NPI: 1447174594
Provider Name (Legal Business Name): BRANDON ALEXANDER CAPALAD DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N MAIN ST
SANDWICH IL
60548-1253
US

IV. Provider business mailing address

381 EVERGREEN CIR
GILBERTS IL
60136-4050
US

V. Phone/Fax

Practice location:
  • Phone: 815-786-8426
  • Fax:
Mailing address:
  • Phone: 224-345-1183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.040184
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: