Healthcare Provider Details

I. General information

NPI: 1013257054
Provider Name (Legal Business Name): KEVIN MICHAEL SLOSS RMA, CHES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2013
Last Update Date: 01/25/2023
Certification Date: 01/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E RANDOLPH ST
CHICAGO IL
60601-5014
US

IV. Provider business mailing address

300 E RANDOLPH ST
CHICAGO IL
60601-5014
US

V. Phone/Fax

Practice location:
  • Phone: 773-597-7210
  • Fax:
Mailing address:
  • Phone: 773-597-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number37489
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: