Provider Demographics
NPI:1861130569
Name:SLATER, ELISA (FNP-C)
Entity type:Individual
Prefix:
First Name:ELISA
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:332 S MICHIGAN AVE STE 900
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-4393
Mailing Address - Country:US
Mailing Address - Phone:855-229-2191
Mailing Address - Fax:312-579-0467
Practice Address - Street 1:2655 WARRENVILLE RD STE 500
Practice Address - Street 2:
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-5646
Practice Address - Country:US
Practice Address - Phone:630-992-0001
Practice Address - Fax:855-273-3924
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL209025241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty