Erica Montgomery, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

096.002552 Issued in IL

Practice address

80 Templeton Dr
Oswego, IL 60543-7000

Phone

(630) 264-8440

NPI assigned

Dec 22, 2021

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Board of Trustees of the University of Illinois

  • Primary Podiatric Medicine Podiatrist
  • Chicago, IL
  • NPI 1518185438
  NPD (past)

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

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740009600000",
    "number": "1558021220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5147 W 64TH PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606385736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 TEMPLETON DR",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437000",
            "telephone_number": "630-264-8440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTGOMERY",
        "first_name": "ERICA",
        "credential": "LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-22",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "IL",
            "license": "096.002552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mindset Counseling
• Gabriella Miskiewicz
• Shalini Mohan, DMD
• Zaira Eyerahi Mondragon Maney, FNP-BC
• Zarahi Montemayor
• Kandise Rose Marie Mooneyham
• Joann Grace Moretti, DDS
• Vito Dominic Moretti, DDS
• Jerry G. Morton, MD
• Michelle S Moses, LCSW

• Athletic Trainer in Oswego, IL
• Providers in Oswego, IL by specialty
• Athletic Trainer in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.