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NPI Code Detail

MEDICARE: SAMANTHA LEVAN

MEDICARE: SAMANTHA LEVAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianIL

General Provider Information

NPI Number : 1407584972
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA LEVAN
Provider Business Mailing Address
First Line : 7322 W 60TH PL
Second Line :
City : SUMMIT ARGO
State : IL
Zip : 60501-1515
Country : US
Telephone Number : 312-978-2924
Fax Number :
Provider Business Practice Location Address
First Line : 3100 S CENTRAL AVE
Second Line :
City : CICERO
State : IL
Zip : 60804-3956
Country : US
Telephone Number : 708-863-3803
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2022
Last Update Date : 01/05/2026

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Directions to “ SAMANTHA LEVAN ” Practice Location

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