Individual
SUSAN P LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8131 LAKE ST, RIVER FOREST, IL 60305-1617
(708) 771-5900
(708) 771-7261
Mailing address
8131 LAKE ST, RIVER FOREST, IL 60305-1617
(708) 771-5900
(708) 771-7261
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0160259040
—
IL
01
—
21605846
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/03/2006
Last updated
07/08/2007
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