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General NPI Number Information
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NPI Number | 1861130569
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Entity Type | Individual
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Provider Name | ELISA SLATER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/23/2022
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2655 WARRENVILLE RD STE 500
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-5646
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Country | US
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Telephone | 630-992-0001
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Fax | 855-273-3924
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Provider Business Mailing Address
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Address Line | 332 S MICHIGAN AVE STE 900
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City | CHICAGO
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State | IL
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Zip | 60604-4393
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Country | US
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Telephone | 855-229-2191
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Fax | 312-579-0467
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209025241
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License Number State | IL
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