Individual
SAMANTHA NICOLE VANDERSLICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1645 W JACKSON BLVD STE 603, CHICAGO, IL 60612-2643
(312) 942-0819
Mailing address
1645 W JACKSON BLVD STE 603, CHICAGO, IL 60612-2643
(312) 942-0819
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036-176914
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036-176914
IL
Other
Enumeration date
03/20/2018
Last updated
09/12/2025
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