Provider Demographics
NPI:1932181807
Name:SLOVEN, DAVID M (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:SLOVEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DAVID
Other - Middle Name:M
Other - Last Name:SLOVEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD SC
Mailing Address - Street 1:4738 N KENMORE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5016
Mailing Address - Country:US
Mailing Address - Phone:773-878-6868
Mailing Address - Fax:
Practice Address - Street 1:4738 N KENMORE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5016
Practice Address - Country:US
Practice Address - Phone:773-878-6868
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG411042084P0800X
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL770460Medicare ID - Type Unspecified
C48967Medicare UPIN