Individual
LISA JEAN LEVY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4419 W NORTH AVE, MELROSE PARK, IL 60160-1021
(773) 777-7112
Mailing address
3021 W CULLOM AVE, CHICAGO, IL 60618-1309
(773) 387-9231
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
299669
IL
Other
Enumeration date
11/14/2017
Last updated
11/14/2017
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