Provider Demographics
NPI:1669568754
Name:UNGACTA, FELIX FLORES (MD)
Entity type:Individual
Prefix:DR
First Name:FELIX
Middle Name:FLORES
Last Name:UNGACTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 APEX DR
Mailing Address - Street 2:SUITE #1
Mailing Address - City:HIGHLAND
Mailing Address - State:IL
Mailing Address - Zip Code:62249-1285
Mailing Address - Country:US
Mailing Address - Phone:618-654-5400
Mailing Address - Fax:618-654-8787
Practice Address - Street 1:30 APEX DR
Practice Address - Street 2:SUITE #1
Practice Address - City:HIGHLAND
Practice Address - State:IL
Practice Address - Zip Code:62249-1285
Practice Address - Country:US
Practice Address - Phone:618-654-5400
Practice Address - Fax:618-654-8787
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-116298207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6402082Medicaid
SDH48747Medicare UPIN
SD6402082Medicaid
ILK45126Medicare PIN