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General NPI Number Information
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NPI Number | 1467259614
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Entity Type | Individual
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Provider Name | ANTONIETTA CAPORALE
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Gender | Female
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Dates
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Enumeration Date | 02/26/2025
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Last Update Date | 02/26/2025
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Provider Practice Location Address
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Address Line | 0S200 WINFIELD RD
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City | WINFIELD
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State | IL
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Zip | 60190-1235
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Country | US
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Telephone | 630-690-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 849 N MERRILL ST
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City | PARK RIDGE
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State | IL
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Zip | 60068-2745
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Country | US
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Telephone |
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 019035515
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License Number State | IL
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