Individual
LISA MICHELE MONTELPASSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9550 W 167TH ST, ORLAND PARK, IL 60467-5561
(708) 873-4500
(708) 873-4530
Mailing address
9550 W 167TH ST, ORLAND PARK, IL 60467-5561
(708) 873-4500
(708) 873-4530
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036103249
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103249
—
IL
01
—
P00176029
R/R MEDICARE
—
Enumeration date
08/20/2006
Last updated
12/20/2021
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