| Montera Health Illinois Llc | |
|
2501 Chatham Rd Ste R Springfield IL 62704-4188 | |
| (865) 680-1516 | |
| Not Available |
| Full Name | Montera Health Illinois Llc |
|---|---|
| Speciality | Behavior Analyst |
| Location | 2501 Chatham Rd Ste R, Springfield, Illinois |
| Authorized Official Name and Position | Qingqing Mao (ADMIN) |
| Authorized Official Contact | 4158051725 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Montera Health Illinois Llc 2501 Chatham Rd Ste R Springfield IL 62704-4188 Ph: (865) 680-1516 | Montera Health Illinois Llc 2501 Chatham Rd Ste R Springfield IL 62704-4188 Ph: (865) 680-1516 |
| NPI Number | 1376299008 |
|---|---|
| Provider Enumeration Date | 02/22/2022 |
| Last Update Date | 01/31/2024 |
| Certification Date | 01/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376299008 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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