Individual
JAMES A. UNTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
830 W DIVERSEY PKWY, SUITE 200, CHICAGO, IL 60614-1454
(773) 880-6040
(773) 880-6107
Mailing address
PO BOX 636, PARK RIDGE, IL 60068-0636
(773) 880-6040
(773) 880-6107
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036071149
IL
208C00000X
Colon & Rectal Surgery Physician
Primary
036071149
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001618161
BCBS OF IL GROUP NUMBER
IL
01
—
020026554
MEDICARE RAILROAD PART B
IL
05
—
036071149
—
IL
Enumeration date
05/27/2006
Last updated
08/24/2009
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