Individual provider · Type 1 NPI

Lacey Montgomery, PA-C

Medical Physician Assistant · Chicago, IL

NPI number 1639166796 Active

Practice location

5841 S Maryland Ave # MC4028
Chicago, IL 60637-1447

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XNone listed

Medical Physician Assistant: Definition to come...

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About NPI 1639166796

Lacey Montgomery, PA-C's National Provider Identifier is 1639166796, issued on Oct 4, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Chicago, IL. The record was last updated on Aug 21, 2007.