Montesano Psychological Center

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

MONTESANO PSYCHOLOGICAL CENTER

Practice address

27135 W Wilmot Rd
Antioch, IL 60002-9165

Phone

(269) 548-9700

NPI assigned

May 2, 2022

Organization subpart

No

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

Authorized official

Name

Liara Montesano

Title

Psychologist

Phone

(269) 548-9700

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676246400000",
    "number": "1831834175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27135 W WILMOT RD",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600029165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27135 W WILMOT RD",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600029165",
            "telephone_number": "269-548-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTESANO PSYCHOLOGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A",
        "authorized_official_last_name": "MONTESANO",
        "authorized_official_first_name": "LIARA",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "269-548-9700"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Antioch, IL
• Providers in Antioch, IL by specialty
• Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.