Provider Demographics
NPI:1558587386
Name:SLAVIN, CARYL LYNN (DT)
Entity Type:Individual
Prefix:MRS
First Name:CARYL
Middle Name:LYNN
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:CARYL
Other - Middle Name:LYNN
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 REVERE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-1564
Mailing Address - Country:US
Mailing Address - Phone:847-291-7905
Mailing Address - Fax:847-291-9641
Practice Address - Street 1:255 REVERE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-1564
Practice Address - Country:US
Practice Address - Phone:847-291-7905
Practice Address - Fax:847-291-9641
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILCS46210698P222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist