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General NPI Number Information
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NPI Number | 1669836144
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Entity Type | Organization
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Legal Business Name | MELANIE S. LEVINE, PH.D., PLLC
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Dates
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Enumeration Date | 04/11/2016
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 155 N MICHIGAN AVE SUITE 560
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City | CHICAGO
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State | IL
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Zip | 60601-7511
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Country | US
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Telephone | 773-413-8394
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Fax |
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Provider Business Mailing Address
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Address Line | 155 N MICHIGAN AVE SUITE 560
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City | CHICAGO
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State | IL
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Zip | 60601-7799
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. MELANIE S. LEVINE
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Credential | PH.D.
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Telephone | 773-413-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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