Provider Demographics
NPI:1265156095
Name:DAMPEER, DENNISAH A
Entity type:Individual
Prefix:
First Name:DENNISAH
Middle Name:A
Last Name:DAMPEER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 W GRANVILLE AVE APT 806
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-2123
Mailing Address - Country:US
Mailing Address - Phone:872-232-5434
Mailing Address - Fax:
Practice Address - Street 1:105 N OAK PARK AVE FL 2
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1364
Practice Address - Country:US
Practice Address - Phone:773-423-8447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health