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General NPI Number Information
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NPI Number | 1730369117
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Entity Type | Individual
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Provider Name | JENNIFER L LEVINE NP
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Gender | Female
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 142 INDIAN SPRINGS DR
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City | SANDWICH
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State | IL
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Zip | 60548-1902
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Country | US
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Telephone | 815-786-2300
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Fax | 815-786-8585
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Provider Business Mailing Address
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Address Line | 27W125 CHESTNUT LN
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City | WINFIELD
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State | IL
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Zip | 60190-2048
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Country | US
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Telephone | 630-667-6759
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | IL
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