Montgomery, Shirley
Montgomery, Shirley is an individual health care provider with primary practice located at 1625 E 75Th St First Floor, Chicago IL 60649-3603. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Montgomery, Shirley can be contacted via phone (773) 947-7500.Contact Information
Primary practice address
1625 E 75Th St First Floor
Chicago IL 60649-3603
Phone: (773) 947-7500
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 036-061800 | Illinois |
Profile Details
| NPI number | 1437192242 |
|---|---|
| LBN Legal business name | Montgomery, Shirley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 13th, 2006 |
| Last updated | Apr 24th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437192242 | NPPES |
| Illinois | MEDICAID | 036-061800 |
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