Provider Demographics
NPI:1184637480
Name:SLUTZKY, MARC W (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:W
Last Name:SLUTZKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E. CHICAGO AVE.
Mailing Address - Street 2:WARD 10-185
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 E CHICAGO AVE
Practice Address - Street 2:WARD 10-185
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-3093
Practice Address - Country:US
Practice Address - Phone:312-695-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology