Provider Demographics
NPI:1639663461
Name:DEMPSTER THERAPEUTIC SERVICES LLC
Entity Type:Organization
Organization Name:DEMPSTER THERAPEUTIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRZEJ
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWANDOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, MHS, MA
Authorized Official - Phone:847-999-3990
Mailing Address - Street 1:9950 LAWRENCE AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:SCHILLER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60176-1216
Mailing Address - Country:US
Mailing Address - Phone:847-999-3990
Mailing Address - Fax:
Practice Address - Street 1:9950 LAWRENCE AVE STE 309
Practice Address - Street 2:
Practice Address - City:SCHILLER PARK
Practice Address - State:IL
Practice Address - Zip Code:60176-1216
Practice Address - Country:US
Practice Address - Phone:847-999-3990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-15
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL146.014096OtherIDFPR LICENSE NUMBER