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1639166796
LACEY MONTGOMERY
CHICAGO, IL
NPI
1639166796
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: IL 085-002214)
Enumeration Date
2005-10-04
Last Update Date
2007-08-21
Business Address
Ms. LACEY MONTGOMERY PA-C
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637-1447
Phone number: 773-834-7136
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Mailing Address
Ms. LACEY MONTGOMERY PA-C
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637-1447
Phone number: 773-834-7136
Copy
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