MEDICARE: DR. IGOR LEVIN M.D.

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	208VP0014X	Interventional Pain Medicine Physician	36286	WI
2	207L00000X	Anesthesiology Physician	36286-020	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376527895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. IGOR LEVIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 735044
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60673-5044
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	975 PORT WASHINGTON RD
Second Line	:
City	:	GRAFTON
State	:	WI
Zip	:	53024-9201
Country	:	US
Telephone Number	:	262-329-2323
Fax Number	:	262-329-1001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2005
Last Update Date	:	10/09/2023

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Directions to “ DR. IGOR LEVIN M.D.” Practice Location

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