Provider Demographics
NPI:1730242439
Name:MONTI, LAURA (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MONTI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 WILEY RD
Mailing Address - Street 2:SUITE 165
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4383
Mailing Address - Country:US
Mailing Address - Phone:847-884-0210
Mailing Address - Fax:847-884-7349
Practice Address - Street 1:1325 WILEY RD
Practice Address - Street 2:SUITE 165
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4383
Practice Address - Country:US
Practice Address - Phone:847-884-0210
Practice Address - Fax:847-884-7349
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006827103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK25655Medicare ID - Type Unspecified