MS. LACEY MONTGOMERY (NPI# 1639166796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639166796 |
| Entity Type | Individual |
| Full Name | MS. LACEY MONTGOMERY |
| Credential | PA-C |
| Practice Address |
5841 S Maryland Ave # Mc4028 Chicago IL 60637-1447 |
| Practice Telephone | 7738347136 |
| Mailing Telephone | 7738347136 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2007-08-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
IL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
5841 S MARYLAND AVE # MC4028 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60637-1447 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558986943 | Yen-yen Susanna Gee | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2020-06-10 |
| 1033732466 | John Charles Wolf | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2020-05-20 |
| 1740802065 | Nitisha Lotun | Student in an Organized Health Care Education/Training Program | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2020-05-08 |
| 1669092136 | Elizabeth Hall | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2020-04-24 |
| 1700406832 | Mary Kathryn Dierks | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2020-04-18 |
| 1821618950 | Mitchell William Lippy | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2020-04-18 |
| 1235759366 | Zachary Chen | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2020-04-18 |
| 1689233801 | Candice Cuppini | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2019-06-11 |
| 1669035168 | Amanda Temple Walborn | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2019-04-19 |
| 1821651761 | Max Von Korzec | Anesthesiology | 5841 S Maryland Ave # Mc4028, Chicago, IL 60637-1443 | 2019-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386263234 | Pooja Ramnani | Pharmacist | 5841 S Maryland Ace, Chicago, IL 60637 | 2020-04-10 |
| 1780220079 | Tara Coleman | Non-emergency Medical Transport (VAN) | 808 E. 63rd Street, Suite 135, Chicago, IL 60637 | 2019-11-21 |
| 1366003501 | Valerie Silas | Case Management | 6330 S King Drive, Chicago, IL 60637 | 2019-06-27 |
| 1205391620 | Derek Joseph Fiedler | Anesthesiology | University of Chicago, 5841 S Maryland Ave, Chicago, IL 60637 | 2019-02-11 |
| 1821573072 | Ugochinyere Ohaja | Registered Nurse | 5656 South Maryland Avenue, Chicago, IL 60637 | 2018-10-03 |
| 1053899138 | Won Hee Oh | Physician Assistant | 5841 S. Maryland Ave., Mc5040, Chicago, IL 60637 | 2018-08-01 |
| 1558854695 | Rasidat Adeduntan | Internal Medicine | 5841 S. Maryland Avenue, [7082], Chicago, IL 60637 | 2018-06-13 |
| 1194235283 | Melissa Ann Arangoa | Registered Nurse | 5841 S. Maryland Ave, Mc 1083, Chicago, IL 60637 | 2017-10-03 |
| 1558880633 | Marni Harris | Optometrist | 5841 S Maryland Ave # S421, Chicago, IL 60637 | 2017-09-11 |
| 1992235105 | Vidya Mahavadi | Pediatrics | 5841 S. Maryland Avenue, Mail Code 8016, Chicago, IL 60637 | 2017-06-20 |
| Find all providers in zip 60637 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518591759 | Julie Jenkot | Physician Assistant | 333 N Michigan Ave Fl 14, Chicago, IL 60601-3901 | 2020-02-26 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1598238883 | Andrea Budzon | Physician Assistant | 2940 N Kimball Ave Apt 2, Chicago, IL 60618-6846 | 2019-01-09 |
| 1760995161 | Leena Abed Hamdan | Physician Assistant | 251 E Huron St Fl 1, Chicago, IL 60611-2908 | 2017-11-08 |
| 1134580079 | Joseph Smith II | Physician Assistant | 654 E 84th St, Chicago, IL 60619-5802 | 2016-03-18 |
| 1679950232 | Alexis Davidman | Physician Assistant | 20 S Clark St Ste, Chicago, IL 60603-1802 | 2015-05-04 |
| 1669861589 | Stewart David Harsant | Physician Assistant | 1702 N Milwaukee Ave, Chicago, IL 60647-5424 | 2015-01-15 |
| 1063817013 | Jenna Lynn Sniegowski | Physician Assistant | 675 N Saint Clair St Fl 21, Chicago, IL 60611-5975 | 2014-11-01 |
| 1851700066 | Lauren Lew | Physician Assistant | 555 West Madison St. Apt 4903, Chicago, IL 60661 | 2014-08-13 |
| 1306270137 | Brianne Patricia Randall | Physician Assistant | California Blvd. At 15th St., Chicago, IL 60608 | 2013-08-28 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.