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MS. LACEY MONTGOMERY PA-C
NPI 1639166796
Physician Assistant - Medical in Chicago, IL

Active since October 04, 2005
5841 S MARYLAND AVE # MC4028, CHICAGO, IL 60637(773) 834-7136 Get Directions Write a Review

NPPES record last updated: August 21, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Ms. Lacey Montgomery Pa-c NPPES

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

MS. LACEY MONTGOMERY PA-C (NPI 1639166796) is an individual medical provider in Chicago, Illinois and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1639166796
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMS. LACEY MONTGOMERYCredential: PA-C
Location Address5841 S MARYLAND AVE # MC4028Chicago, IL 60637-1447
Mailing Address5841 S Maryland Ave # Mc4028Chicago, IL 60637-1447 · (773) 834-7136
Phone(773) 834-7136
Sole ProprietorNo
Enumeration DateOctober 4, 2005
Last NPPES UpdateAugust 21, 2007
✔ NPI 1639166796 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
5841 S MARYLAND AVE # MC4028, Chicago, IL 60637
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Other Identifiers 2

Medicare ID-Type UnspecifiedK17252/208534IL
Medicare UPINQ42879IL

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JORY S BOND
Anesthesiology
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842
JOHN SUN MD
Student in an Organized Health Care Education/Training Program
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842
KISHAN H PATEL MD
Anesthesiology
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842
JOHN CHARLES WOLF MD
Anesthesiology
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842
RAVEN WRIGHT MD
Anesthesiology
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842
DHAVAN NILESH SHAH MD
Anesthesiology
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842
THOMAS A BIELAWIEC MD
Anesthesiology
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842
MAX TUCKER ACKERMAN BS
Anesthesiology
5841 S MARYLAND AVE # MC4028
CHICAGO, IL 60637
Cook County (773) 702-6842

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 Lacey Montgomery's NPI number?

The NPI number for Lacey Montgomery is 1639166796. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Lacey Montgomery located?

Lacey Montgomery practices at 5841 S Maryland Ave # Mc4028, Chicago, IL 60637. The listed phone number is (773) 834-7136.

What is Lacey Montgomery's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Lacey Montgomery was last updated on August 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.