Individual
ERICA SLATTERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
671 S LEWIS AVE, WAUKEGAN, IL 60085-6101
(847) 782-4000
Mailing address
5645 W LAKE ST, CHICAGO, IL 60644-1956
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295154813
—
IL
Enumeration date
10/20/2020
Last updated
10/20/2020
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