Provider Demographics
NPI:1700187531
Name:COLARETA UGARTE, URSULA PATRICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:URSULA
Middle Name:PATRICIA
Last Name:COLARETA UGARTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1444 CAROL ST APT A
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1290
Mailing Address - Country:US
Mailing Address - Phone:347-848-7022
Mailing Address - Fax:
Practice Address - Street 1:1444 CAROL ST APT A
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1290
Practice Address - Country:US
Practice Address - Phone:347-848-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361268092080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine