Organization
MONTERA HEALTH ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
QINGQING MAO (ADMIN)
(415) 805-1725
Entity
Organization
Contact information
Practice address
2501 CHATHAM RD STE R, SPRINGFIELD, IL 62704-4188
(865) 680-1516
Mailing address
2501 CHATHAM RD STE R, SPRINGFIELD, IL 62704-4188
(865) 680-1516
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
01/31/2024
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