MEDICARE: DARI ANN UNGARETTI DO

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	207N00000X	Dermatology Physician	036097381	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00611330	OTHER	IL	RAILROAD MEDICARE
3	070016282	OTHER	IL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	04530336	OTHER	IL	BCBS PROVIDER ID

General Provider Information

NPI Number	:	1548256746
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARI ANN UNGARETTI DO

Provider Business Mailing Address
First Line	:	777 OAKMONT LN
Second Line	:	SUITE 1600
City	:	WESTMONT
State	:	IL
Zip	:	60559-5511
Country	:	US
Telephone Number	:	630-789-2550
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 N RANDALL RD
Second Line	:	SUITE 380
City	:	ELGIN
State	:	IL
Zip	:	60123-9400
Country	:	US
Telephone Number	:	847-742-1000
Fax Number	:	847-742-1144

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	03/10/2009

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Directions to “ DARI ANN UNGARETTI DO” Practice Location

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