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Individual

TREVOR J SLOM

Active
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Individual

TREVOR J SLOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
036-095393
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001636111
BLUE CROSS BLUE SHIELD OF IL
IL
05
036095393
IL
05
205454606
MO
01
615318700
US DEPT OF LABOR - 2222 DIVISION, CHICAGO LOCATION
IL
01
615318701
US DEPT OF LABOR-2001 CALIFORNIA, CHICAGO LOCATION
IL
Enumeration date
03/01/2006
Last updated
11/15/2018
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