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NPI Code Detail

MEDICARE: STEPHEN M. SLADEK M.D.

MEDICARE: STEPHEN M. SLADEK M.D.
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
1207Q00000XFamily Medicine Physician036133124IL

General Provider Information

NPI Number : 1770562563
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN M. SLADEK M.D.
Provider Business Mailing Address
First Line : 9555 S 52ND AVE
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-3054
Country : US
Telephone Number : 708-422-5700
Fax Number : 708-422-8225
Provider Business Practice Location Address
First Line : 9555 S 52ND AVE
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-3054
Country : US
Telephone Number : 708-422-5700
Fax Number : 708-422-8225
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 12/13/2021

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Directions to “ STEPHEN M. SLADEK M.D.” Practice Location

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