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ELLEN PETACQUE MONTGOMERY
NPI 1104625805
Social Worker - Clinical in Chicago, IL

Active since March 13, 2025
1743 N SEDGWICK ST, CHICAGO, IL 60614(312) 318-0260 Get Directions Write a Review

NPPES record last updated: March 13, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ellen Petacque Montgomery NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELLEN PETACQUE MONTGOMERY (NPI 1104625805) is an individual clinical provider in Chicago, Illinois, licensed in Illinois (149007355) and active in the NPI registry since March 2025. She maintains a secondary practice location in Chicago.

NPPES Registry Identity

NPI1104625805
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameELLEN PETACQUE MONTGOMERY
Location Address1743 N SEDGWICK STChicago, IL 60614-5721
Mailing Address1743 N Sedgwick StChicago, IL 60614-5721 · (312) 318-0260
Phone(312) 318-0260
Sole ProprietorNo
Enumeration DateMarch 13, 2025
NPPES CertifiedMarch 13, 2025
✔ NPI 1104625805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IL · 149007355
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
1743 N SEDGWICK ST, Chicago, IL 60614
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Other Names 1

Professional Name (2)Ellen Petacque

Secondary Practice Location 1

Location 11743 N Sedgwick StChicago, IL 60614-5721 · Phone (312) 318-0260

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ellen Montgomery's NPI number?

The NPI number for Ellen Montgomery is 1104625805. It was assigned to this individual provider in the NPPES registry on March 13, 2025. The provider is also known as Ellen Petacque.

Where is Ellen Montgomery located?

Ellen Montgomery practices at 1743 N Sedgwick St, Chicago, IL 60614. The listed phone number is (312) 318-0260.

What is Ellen Montgomery's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Ellen Montgomery was last updated on March 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.