Provider Demographics
NPI:1811085053
Name:MONTES, FAYE S (MD)
Entity type:Individual
Prefix:MRS
First Name:FAYE
Middle Name:S
Last Name:MONTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:FAYE
Other - Middle Name:PB
Other - Last Name:MONTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:15 TOWER CT
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031
Mailing Address - Country:US
Mailing Address - Phone:847-623-4464
Mailing Address - Fax:847-623-9984
Practice Address - Street 1:15 TOWER CT
Practice Address - Street 2:SUITE 150
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031
Practice Address - Country:US
Practice Address - Phone:847-623-4464
Practice Address - Fax:847-623-9984
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096532208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036096532Medicaid