Provider Demographics
NPI:1326185976
Name:DIMANTE, JANETA (MD)
Entity type:Individual
Prefix:DR
First Name:JANETA
Middle Name:
Last Name:DIMANTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:302 RANDALL RD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4209
Mailing Address - Country:US
Mailing Address - Phone:630-262-2751
Mailing Address - Fax:630-262-2755
Practice Address - Street 1:302 RANDALL RD.
Practice Address - Street 2:SUITE 305
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134
Practice Address - Country:US
Practice Address - Phone:630-262-2751
Practice Address - Fax:630-262-2755
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL36114487207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILI11325Medicare UPIN