Provider Demographics
NPI:1659850436
Name:ALCHEMY PERFORMANCE CONSULTING, LLC
Entity Type:Organization
Organization Name:ALCHEMY PERFORMANCE CONSULTING, LLC
Other - Org Name:MICHELLE MONTERO, PSYD
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MONTERO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-542-3408
Mailing Address - Street 1:5204 N LEAVITT ST APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-1805
Mailing Address - Country:US
Mailing Address - Phone:765-215-5052
Mailing Address - Fax:
Practice Address - Street 1:4737 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-7758
Practice Address - Country:US
Practice Address - Phone:773-542-3408
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-12
Last Update Date:2018-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009074103TC0700X, 261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty