Healthcare Provider Details

I. General information

NPI: 1821900010
Provider Name (Legal Business Name): AMBERLEE JOY WEBSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 N RACINE AVE UNIT 300
CHICAGO IL
60614-7006
US

IV. Provider business mailing address

1850 N CLARK ST APT 402
CHICAGO IL
60614-5335
US

V. Phone/Fax

Practice location:
  • Phone: 773-413-9523
  • Fax:
Mailing address:
  • Phone: 920-819-4580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number178.033376
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: