Individual
CONSTANTINA K. SLOFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2650 RIDGE AVE., DEPARTMENT OF PSYCHIATRY, EVANSTON, IL 60201-1718
(847) 425-6400
(847) 425-6408
Mailing address
2650 RIDGE AVE., DEPARTMENT OF PSYCHIATRY, EVANSTON, IL 60201-1718
(847) 425-6400
(847) 425-6408
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085005366
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01261832
MEDICARE RR PTAN
IN
Enumeration date
06/18/2006
Last updated
05/27/2021
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