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NPI Code Detail

MEDICARE: ADAM SLOTA MA CCC-SLP

MEDICARE: ADAM SLOTA MA CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist146009889IL

General Provider Information

NPI Number : 1376863225
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM SLOTA MA CCC-SLP
Provider Business Mailing Address
First Line : 7733 W GRAND AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-1820
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7733 W GRAND AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-1820
Country : US
Telephone Number : 708-453-0084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2010
Last Update Date : 06/02/2010

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Directions to “ ADAM SLOTA MA CCC-SLP” Practice Location

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