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General NPI Number Information
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NPI Number | 1457308926
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Entity Type | Individual
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Provider Name | DEEPAK KAPOOR M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 12/23/2013
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Provider Practice Location Address
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Address Line | 9700 KENTON AVE SUITE K-205
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City | SKOKIE
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State | IL
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Zip | 60076-1259
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Country | US
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Telephone | 847-673-8005
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Fax | 847-673-8719
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Provider Business Mailing Address
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Address Line | 1107 EDMER AVE
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City | OAK PARK
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State | IL
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Zip | 60302-1131
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Country | US
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Telephone | 708-386-4818
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Fax | 312-864-8014
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 36050298
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 36050298
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License Number State | IL
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