Organization
MONTGOMERY PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY FRANCES VON GOEBEN LNHA (ADMINISTRATOR/DIRECTOR OF OPERATION)
(773) 617-1447
Entity
Organization
Contact information
Practice address
5550 S SHORE DR, CHICAGO, IL 60637-5051
(773) 753-4100
(773) 752-0056
Mailing address
5550 S SHORE DR, CHICAGO, IL 60637-5051
(773) 753-4100
(773) 752-0056
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
11/01/2010
Last updated
11/01/2010
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