Individual
ELLEN PETACQUE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1743 N SEDGWICK ST, CHICAGO, IL 60614-5721
(312) 318-0260
Mailing address
1743 N SEDGWICK ST, CHICAGO, IL 60614-5721
(312) 318-0260
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149007355
IL
Other
Enumeration date
03/13/2025
Last updated
03/13/2025
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