Provider Demographics
NPI:1669639837
Name:MONTGOMERY, JENNIFER LEIGH (AUD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEIGH
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 W HIGGINS RD
Mailing Address - Street 2:STE 895
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-2071
Mailing Address - Country:US
Mailing Address - Phone:847-843-1900
Mailing Address - Fax:
Practice Address - Street 1:5208 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5712
Practice Address - Country:US
Practice Address - Phone:210-267-9374
Practice Address - Fax:210-267-9394
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX80333237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter