Provider Demographics
NPI:1447581814
Name:MONTANEZ, ORALIA EVA (LMT)
Entity Type:Individual
Prefix:
First Name:ORALIA
Middle Name:EVA
Last Name:MONTANEZ
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 COUR DALENE
Mailing Address - Street 2:
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-2404
Mailing Address - Country:US
Mailing Address - Phone:708-334-6708
Mailing Address - Fax:
Practice Address - Street 1:19 COUR DALENE
Practice Address - Street 2:
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-2404
Practice Address - Country:US
Practice Address - Phone:708-334-6708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-24
Last Update Date:2010-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL227.008829225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL227.008829OtherLMT