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NPI Code Detail

MEDICARE: MS. AQUANTONETTE SLAUGHTER LPC

MEDICARE: MS. AQUANTONETTE SLAUGHTER LPC
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
1101YM0800XMental Health Counselor178.010081IL

General Provider Information

NPI Number : 1447756788
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. AQUANTONETTE SLAUGHTER LPC
Provider Business Mailing Address
First Line : 222 S JEFFERSON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60661-5603
Country : US
Telephone Number : 312-441-9009
Fax Number : 312-441-9019
Provider Business Practice Location Address
First Line : 1140 W 79TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60620-3029
Country : US
Telephone Number : 773-962-2683
Fax Number : 773-962-2699
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2018
Last Update Date : 02/08/2024

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Directions to “ MS. AQUANTONETTE SLAUGHTER LPC” Practice Location

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