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General NPI Number Information
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NPI Number | 1003494709
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Entity Type | Individual
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Provider Name | NICHOLAS PATRICK SLATTERY MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 300 RANDALL RD
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City | GENEVA
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State | IL
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Zip | 60134-4200
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Country | US
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Telephone | 630-208-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 300 RANDALL RD
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City | GENEVA
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State | IL
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Zip | 60134-4200
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Country | US
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Telephone | 630-217-5207
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 036.167349
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License Number State | IL
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