MEDICARE: DR. JANE LOUISE KAPRAL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	036-070280	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033221767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE LOUISE KAPRAL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 781
Second Line	:
City	:	KANKAKEE
State	:	IL
Zip	:	60901-0781
Country	:	US
Telephone Number	:	815-935-7538
Fax Number	:	815-935-7340

Provider Business Practice Location Address
First Line	:	5775 E STATE ROUTE 113
Second Line	:
City	:	COAL CITY
State	:	IL
Zip	:	60416-7111
Country	:	US
Telephone Number	:	815-634-0100
Fax Number	:	816-634-2900

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/01/2010

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