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General NPI Number Information
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NPI Number | 1306402037
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Entity Type | Organization
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Legal Business Name | LEVIN OCCUPATIONAL THERAPY LLC
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 1217 GREEN BAY RD
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City | WILMETTE
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State | IL
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Zip | 60091-1643
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Country | US
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Telephone | 847-251-1717
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Fax |
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Provider Business Mailing Address
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Address Line | 1217 GREEN BAY RD
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City | WILMETTE
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State | IL
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Zip | 60091-1643
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Country | US
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Telephone | 847-251-1717
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARA LEVIN
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Credential | OT
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Telephone | 847-251-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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