Individual
DR. DOUG ALAN MONTEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036102050
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102050
—
IL
01
—
BLUE SHIELD PROVIDER
01633446
IL
01
—
COMM PROVIDER #
203712521
IL
01
—
RR MEDICARE #
P00023316
IL
Enumeration date
11/15/2006
Last updated
05/07/2013
Update your record
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