Individual
MICHELE MONTALBANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2197 BLACKBERRY DR STE A, GENEVA, IL 60134-4713
(630) 365-2020
(630) 365-9828
Mailing address
2197 BLACKBERRY DR, GENEVA, IL 60134-4713
(630) 365-2020
(630) 365-9828
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-008820
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04532352
BCBS
IL
01
—
1407043177
HUMANA/UNITED HEALTHCARE
IL
01
—
IL6941
MEDICARE PTAN/ ORGANIZATION
IL
01
—
IL6941001
MEDICARE PTAN/ INDIVIDUAL
IL
Enumeration date
10/16/2006
Last updated
03/07/2023
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