Basic Information
| Provider Information | |||||||||
| NPI: | 1033221767 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KAPRAL | ||||||||
| FirstName: | JANE | ||||||||
| MiddleName: | LOUISE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 781 | ||||||||
| Address2: | |||||||||
| City: | KANKAKEE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 609010781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8159357538 | ||||||||
| FaxNumber: | 8159357340 | ||||||||
| Practice Location | |||||||||
| Address1: | 5775 E STATE ROUTE 113 | ||||||||
| Address2: | |||||||||
| City: | COAL CITY | ||||||||
| State: | IL | ||||||||
| PostalCode: | 604167111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156340100 | ||||||||
| FaxNumber: | 8166342900 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 02/01/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 036-070280 | IL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 036-070280 | 05 | IL | MEDICAID |