Organization
DOUG MONTEITH M.D., S.C. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUG ALAN MONTEITH M.D. (PRESIDENT)
(773) 907-3060
Entity
Organization
Contact information
Practice address
2740 W FOSTER AVE, #401, CHICAGO, IL 60625-3500
(773) 907-3060
(773) 907-3061
Mailing address
2740 W FOSTER AVE, #417, CHICAGO, IL 60625-3500
(773) 907-3060
(773) 907-3061
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01633446
BLUE SHIELD PROVIDER #
IL
01
—
P00023316
RR MEDICARE PROVIDER #
IL
Enumeration date
11/15/2006
Last updated
04/20/2008
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