Provider Demographics
NPI:1548256746
Name:UNGARETTI, DARI ANN (DO)
Entity type:Individual
Prefix:
First Name:DARI ANN
Middle Name:
Last Name:UNGARETTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 OAKMONT LN
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:WESTMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60559-5511
Mailing Address - Country:US
Mailing Address - Phone:630-789-2550
Mailing Address - Fax:
Practice Address - Street 1:1710 N RANDALL RD
Practice Address - Street 2:SUITE 380
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-9400
Practice Address - Country:US
Practice Address - Phone:847-742-1000
Practice Address - Fax:847-742-1144
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2009-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097381207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP00611330OtherRAILROAD MEDICARE
IL036097381Medicaid
IL070016282OtherRAILROAD MEDICARE
IL04530336OtherBCBS PROVIDER ID
ILK07881Medicare PIN
ILP00611330OtherRAILROAD MEDICARE
IL036097381Medicaid