Individual
DR. BRETT R. LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
1611 W HARRISON ST, STE 400, CHICAGO, IL 60612-3841
(312) 243-4244
(312) 942-1517
Mailing address
1 WESTBROOK CORPORATE CTR, #240, WESTCHESTER, IL 60154-5701
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
036113094
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113094 1
—
IL
01
—
1633878
BCBS OF ILLINOIS
IL
01
—
207067
MEDICARE PTAN LOCALITY #16
IL
01
—
207073
MEDICARE PTAN LOCALITY #15
IL
01
—
DA4902
RRMEDICARE PTAN NUMBER
IL
01
—
P00309999
RR MEDICARE NUMBER
IL
Enumeration date
01/13/2006
Last updated
09/18/2018
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