Organization
DOUG MONTEITH M.D., S.C. INC
Active
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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