| Doctor Name: | MR. ELMER JOHN CAPINA |
| NPI Number: | 1063408417 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | 085-002220 |
| Business Practice Address: | 901 Mcclintock Dr Suite 202 Burr Ridge, IL - 605270872 |
| Business Phone Number: | 8882206432 |
| Business Fax Number: | 6306544253 |
| Mailing Address: | 901 Mcclintock Dr, Suite 202 BURR RIDGE |
| State: | IL |
| Postal Code: | 605270872 |
| Phone Number: | 8882206432 |
| Fax Number: | 6306544253 |
| NPI Enumeration Date: | 09/21/2005 |
| NPI Last Update Date: | 05/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 085-002220 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |