MEDICARE: KATHRYN R LEVITAN ND

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	171400000X	Health & Wellness Coach		IL

General Provider Information

NPI Number	:	1487587754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN R LEVITAN ND

Provider Business Mailing Address
First Line	:	980 N MICHIGAN AVE STE 1090 PMB 168662 CHICAGO, ILLINOI
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4521
Country	:	US
Telephone Number	:	304-380-8691
Fax Number	:

Provider Business Practice Location Address
First Line	:	540 W WELLINGTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5457
Country	:	US
Telephone Number	:	304-380-8691
Fax Number	:

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

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/10/2026

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