MEDICARE: MRS. COLLEEN M LEVITZ MSPT

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
1	225100000X	Physical Therapist	4507745	IL

General Provider Information

NPI Number	:	1558344911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. COLLEEN M LEVITZ MSPT

Provider Business Mailing Address
First Line	:	666 DUNDEE RD
Second Line	:	SUITE 1002
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-2727
Country	:	US
Telephone Number	:	847-714-7400
Fax Number	:

Provider Business Practice Location Address
First Line	:	666 DUNDEE RD
Second Line	:	SUITE 1002
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-2727
Country	:	US
Telephone Number	:	847-714-7400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2005
Last Update Date	:	10/13/2009

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