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Individual

UMA S LEVY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
885 ROOSEVELT RD, GLEN ELLYN, IL 60137-6141
(630) 790-1555
Mailing address
885 ROOSEVELT RD, GLEN ELLYN, IL 60137-6141
(630) 790-1555

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-106818
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
920540
MEDICARE PTAN GROUP
IL
01
F400223272
MEDICARE PTAN INDIVIDUAL
IL
Enumeration date
09/13/2006
Last updated
07/23/2015
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