Provider Demographics
NPI:1528184629
Name:RANIELI, MARY C (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:C
Last Name:RANIELI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66414
Mailing Address - Street 2:O'HARE INTERNATIONAL AIRPORT-HILTON ARCADE LEVEL
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60666-0414
Mailing Address - Country:US
Mailing Address - Phone:773-601-8900
Mailing Address - Fax:773-601-8988
Practice Address - Street 1:11601 WEST TOUHY AVENUE
Practice Address - Street 2:O'HARE INTERNATIONAL AIRPORT-HILTON ARCADE LEVEL
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60666
Practice Address - Country:US
Practice Address - Phone:773-601-8900
Practice Address - Fax:773-601-8988
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice