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General NPI Number Information
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NPI Number | 1598300105
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Entity Type | Individual
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Provider Name | REBECCA SARAH LEVIN LCSW
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Gender | Female
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Dates
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Enumeration Date | 11/07/2019
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-563-1059
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 W BELMONT AVE UNIT 302
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City | CHICAGO
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State | IL
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Zip | 60618-6664
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Country | US
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Telephone | 847-682-1466
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149021758
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License Number State | IL
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