Shirley Montgomery, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

036-061800 Issued in IL

Practice address

1625 E 75TH St
First Floor
Chicago, IL 60649-3603

Phone

(773) 947-7500

NPI assigned

Jun 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shirleymontgomery@jph.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Friedell Clinic, S. C.

  • Family Medicine Physician
  • Chicago, IL
  • NPI 1306854021

  Pediatrics

  Medicare reassignment NPD
• Great Lakes Emergency Physicians Medical Group SC

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1689212581
  Medicare reassignment NPD
• Jackson Park Hospital Foundation

  • General Acute Care Hospital
  • Chicago, IL
  • NPI 1497750699
  NPD
• Midwest Neoped Associates LTD

  • Specialist
  • Oak Brook, IL
  • NPI 1396792180
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1437192242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 E 75TH ST",
            "address_2": "FIRST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493603",
            "telephone_number": "773-947-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 E 75TH ST",
            "address_2": "FIRST FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606493603",
            "telephone_number": "773-947-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "SHIRLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-061800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-061800",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lacey Montgomery, PA-C
• Maria Montgomery, RN
• Mark Joseph Montgomery
• Miracle Donique Montgomery, LCSW
• Philip Darian Montgomery, LPC
• Taylor Montgomery
• Christopher Erik Monti, MD, PHD
• Denise Monti, MD, MPH
• Christopher Montiel
• Fabiola Montiel, PSYD

• Pediatrics Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.