Provider Demographics
NPI:1154593473
Name:MOROTE SANCHEZ, SALVADOR G (PSYD, MA, LCPC)
Entity type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:G
Last Name:MOROTE SANCHEZ
Suffix:
Gender:M
Credentials:PSYD, MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 W DAKIN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60641-2608
Mailing Address - Country:US
Mailing Address - Phone:773-725-8432
Mailing Address - Fax:
Practice Address - Street 1:10001 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-2563
Practice Address - Country:US
Practice Address - Phone:847-451-0330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006242101YP2500X, 101YM0800X, 103T00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist