Provider Demographics
NPI:1427127976
Name:DENNIS, AMBER LEE (MS CCC-SLP/L)
Entity type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:LEE
Last Name:DENNIS
Suffix:
Gender:F
Credentials:MS CCC-SLP/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 HALIFAX RD
Mailing Address - Street 2:
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-4747
Mailing Address - Country:US
Mailing Address - Phone:224-433-6721
Mailing Address - Fax:
Practice Address - Street 1:17371 W GAGES LAKE RD
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-1830
Practice Address - Country:US
Practice Address - Phone:847-984-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.008300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist