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General NPI Number Information
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NPI Number | 1750854733
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Entity Type | Individual
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Provider Name | LAUREN LEVIN
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Gender | Female
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Dates
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Enumeration Date | 01/02/2019
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Last Update Date | 05/21/2019
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Provider Practice Location Address
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Address Line | 2650 RIDGE AVE
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City | EVANSTON
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State | IL
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Zip | 60201-1700
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Country | US
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Telephone | 847-570-2760
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Fax |
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Provider Business Mailing Address
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Address Line | 1164 W MADISON ST UNIT 220
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City | CHICAGO
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State | IL
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Zip | 60607-3867
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Country | US
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Telephone | 219-313-9835
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 041384384
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 209018584
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License Number State | IL
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