Provider Demographics
NPI:1770896326
Name:SLATER, BROOKE SARA (SLP)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:SARA
Last Name:SLATER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 W WHITEHALL DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-7907
Mailing Address - Country:US
Mailing Address - Phone:847-845-5633
Mailing Address - Fax:
Practice Address - Street 1:423 W WHITEHALL DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-7907
Practice Address - Country:US
Practice Address - Phone:847-845-5633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.010276235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist