Amanda Jean Slater, PSYD
Individual provider Active NPI Clinical Psychologist · Palos Heights, IL
NPI 1366090201 · NPPES record last updated Oct 11, 2024
Key facts
- NPI
- 1366090201
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 071010729 (IL)
- Practice address
- 11800 S 75TH Ave Ste 300
Palos Heights, IL 60463-1064 - Phone
- (708) 671-8440
- NPI assigned
- Sep 3, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Adventist Midwest Health
Practice addresses (Care Compare)
1325 Community Memorial Dr
La Grange, IL 60525-2659
Phone (708) 245-8900
5101 Willow Springs Rd
La Grange, IL 60525-2600
Phone (708) 245-9000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230712003622 | IL | Practitioner - Clinical Psychologist | 2062872849 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071010729 | IL | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mira Neuro Behavioral Health Care, LLC | Current |
Accepting new patients | |
| Adventist Midwest Health | Current |
Accepting new patients | |
| Miracare Neuro Behavioral Health, PC | Counselor | Current |
Accepting new patients |
| Midwest Medical Center | Current |
Accepting new patients | |
| Adventist Midwest Health | Current |
Accepting new patients | |
| Midwest Medical Center | Current |
Accepting new patients |
Locations
1 Medical Center Dr
Galena, IL 61036
Phone (815) 776-7381
5101 Willow Springs Rd
Lagrange Hlds, IL 60525
Phone (708) 245-4073
11800 S 75th Ave
Ste 300
Palos Heights, IL 60463
Phone (708) 671-8440
Interoperability endpoints
- midwestmedical@midwestmedicalcenter.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 071010729 | IL | |
| Clinical Psychologist | 103TC0700X | 071010729 | IL | Yes |
Addresses
Primary practice location
11800 S 75TH Ave Ste 300
Palos Heights, IL 60463-1064
Mailing address
11800 S 75TH Ave Ste 300
Palos Heights, IL 60463-1064
Phone (708) 671-8440
Other practice location 1
1 Medical Center Dr
Galena, IL 61036-8118
Phone (815) 776-7381
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | midwestmedical@midwestmedicalcenter.cernerdirect.com | Direct |
Other providers in Palos Heights, IL
- James Sitzberger
- George I. Skarpathiotis
- Stratos George Skarpathiotis
- Migle Skindaraite
- Janice Marie Skwarczyk
- Samantha Slutzky
- James Kenneth Smedegard
- Smiles in Style LLC
- Elizabeth Nicole Smith
- Kristin Joy Smith
All providers in Palos Heights, IL · Clinical Psychologist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.