Healthcare Provider Details

I. General information

NPI: 1831008598
Provider Name (Legal Business Name): LAKEFRONT SPEECH THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 PLYMOUTH DR
INVERNESS IL
60067-4628
US

IV. Provider business mailing address

350 PLYMOUTH DR
INVERNESS IL
60067-4628
US

V. Phone/Fax

Practice location:
  • Phone: 847-494-2714
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: ELENA SORRENTINO
Title or Position: OWNER
Credential: M.S., CCC-SLP
Phone: 847-494-2714