Provider Demographics
NPI:1598597908
Name:SALAAM, TONY FASEEH (LCSW)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:FASEEH
Last Name:SALAAM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5747 S MICHIGAN AVE APT 1N
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1161
Mailing Address - Country:US
Mailing Address - Phone:312-493-8990
Mailing Address - Fax:
Practice Address - Street 1:5747 S MICHIGAN AVE APT 1N
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1161
Practice Address - Country:US
Practice Address - Phone:312-493-8990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL886941768103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling