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GLENDA LOIS MONTAGUE M.D.

Physicians Otolaryngology

Provider NPI: 1043508872

Provider Information:
 GLENDA LOIS MONTAGUE M.D.
Gender: F
Sole Proprietor

Practice Location:
5814 S MARYLAND AVE U OF CHICAGO ENT MC 1035 ROOM E-102 C/O SHANNA JONES CHICAGO, IL 60637-1462 US
Tel: 773-795-3158  Fax: --

Business Mailing Address:
5814 S MARYLAND AVE U OF CHICAGO ENT MC 1035 ROOM E-102 C/O SHANNA JONES CHICAGO, IL 60637-1462 US
Tel: 773-795-3158  Fax: --

NPI Information:
NPI: 1043508872
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Y00000XPhysicians
Otolaryngology
CAA142034
N207YX0602XPhysicians
Otolaryngology
IL125060100

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 207Y00000X

Type:

Classification:



Definition:



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