Healthcare Provider Details

I. General information

NPI: 1578474839
Provider Name (Legal Business Name): KATHERINE SLAYTON PSYD
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7110 W 127TH ST STE 150
PALOS HEIGHTS IL
60463-1579
US

IV. Provider business mailing address

7110 W 127TH ST STE 150
PALOS HEIGHTS IL
60463-1579
US

V. Phone/Fax

Practice location:
  • Phone: 708-419-3171
  • Fax:
Mailing address:
  • Phone: 708-419-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number071023420
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: