Healthcare Provider Details

I. General information

NPI: 1962050088
Provider Name (Legal Business Name): MARIA ISABEL MONTOYA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2019
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N OAK PARK AVE
OAK PARK IL
60301-1364
US

IV. Provider business mailing address

1308 CABOT LN
SCHAUMBURG IL
60193-2517
US

V. Phone/Fax

Practice location:
  • Phone: 773-423-8447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.018017
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: