MEDICARE: LAKEFRONT THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1104618198
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKEFRONT THERAPY LLC

Provider Business Mailing Address
First Line	:	120 N YORK ST STE 202
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-2827
Country	:	US
Telephone Number	:	630-244-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	120 N YORK ST STE 202
Second Line	:
City	:	ELMHURST
State	:	IL
Zip	:	60126-2827
Country	:	US
Telephone Number	:	630-244-5299
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JASMIN DEMARCO
Credential	:	LCPC
Telephone Number	:	630-244-5299

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

Similar Medicare Providers

1124842315 — KARSYN PRESCOTT
Practice Location Address:

120 N YORK ST STE 202
ELMHURST, IL
60126-2827

Practice Phone: 630-244-5299
Practice Fax:

1114994662 — ADVOCATE HOME CARE PRODUCTS, INC
Practice Location Address:

949 N LARCH AVE
ELMHURST, IL
60126-1128

Practice Phone: 630-516-3100
Practice Fax: 630-516-3130

1043624760 — PABLO NICOLAS QUINTANA M.D.
Practice Location Address:

133 E BRUSH HILL RD
ELMHURST, IL
60126-5659

Practice Phone: 331-221-8952
Practice Fax:

1063840270 — DR. SUSAN E WOODEN PHARM.D.
Practice Location Address:

678 N YORK ST
ELMHURST, IL
60126-1605

Practice Phone: 630-782-0031
Practice Fax: 630-782-0048

1053152629 — AMY BRAVATTY LCSW
Practice Location Address:

340 W BUTTERFIELD RD STE LLB
ELMHURST, IL
60126-5024

Practice Phone: 630-474-8919
Practice Fax:

1447183272 — ERIKA JANINA TAPIA
Practice Location Address:

155 E BRUSH HILL RD
ELMHURST, IL
60126-5658

Practice Phone: 331-221-1000
Practice Fax:

Directions to “LAKEFRONT THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.