Provider Demographics
NPI:1528217510
Name:SALERNO, AMY F (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:F
Last Name:SALERNO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 SANDLEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LAKE VILLA
Mailing Address - State:IL
Mailing Address - Zip Code:60046-9067
Mailing Address - Country:US
Mailing Address - Phone:847-308-2995
Mailing Address - Fax:
Practice Address - Street 1:1860 W WINCHESTER RD
Practice Address - Street 2:
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5351
Practice Address - Country:US
Practice Address - Phone:847-573-9486
Practice Address - Fax:847-549-6139
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist