Individual
SHIRLEY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1625 E 75TH ST, FIRST FLOOR, CHICAGO, IL 60649-3603
(773) 947-7500
Mailing address
1625 E 75TH ST, FIRST FLOOR, CHICAGO, IL 60649-3603
(773) 947-7500
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-061800
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-061800
—
IL
Enumeration date
06/13/2006
Last updated
04/24/2013
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