Provider Demographics
NPI:1043659907
Name:CATARINICCHIA, ANGELA (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:CATARINICCHIA
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 1:2111 E OAKLAND AVE
Mailing Address - Street 2:STE B
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-5783
Mailing Address - Country:US
Mailing Address - Phone:303-498-3440
Mailing Address - Fax:303-498-3445
Practice Address - Street 1:1606 PRAIRIE CENTER PKWY STE 350
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:CO
Practice Address - Zip Code:80601-4005
Practice Address - Country:US
Practice Address - Phone:303-498-3440
Practice Address - Fax:303-498-3445
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0055675207V00000X
IL036150348207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology