Provider Demographics
NPI:1386765642
Name:SLONKA, THOMAS (LCSW, CADC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:SLONKA
Suffix:
Gender:M
Credentials:LCSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SALT CREEK LN STE 202
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-2903
Mailing Address - Country:US
Mailing Address - Phone:331-221-2505
Mailing Address - Fax:331-221-2719
Practice Address - Street 1:8 SALT CREEK LN STE 202
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2903
Practice Address - Country:US
Practice Address - Phone:331-221-2505
Practice Address - Fax:331-221-2719
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0027991041C0700X
IL16634101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILS27169Medicare UPIN