Montgomery, Lacey

Montgomery, Lacey is an individual health care provider with primary practice located at 5841 S Maryland Ave # Mc4028 , Chicago IL 60637-1447. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Montgomery, Lacey can be contacted via phone (773) 834-7136.

Contact Information

Primary practice address
5841 S Maryland Ave # Mc4028 Chicago IL 60637-1447
Phone: (773) 834-7136
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X Illinois

Profile Details

NPI number 1639166796
LBN Legal business name Montgomery, Lacey
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Aug 21st, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers