Organization
RICHARD A. LEVY, MD LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD A. LEVY M.D. (OWNER)
(312) 942-8989
Entity
Organization
Contact information
Practice address
1725 W HARRISON ST, SUITE 328, CHICAGO, IL 60612-3841
(312) 942-8989
(312) 942-2359
Mailing address
PO BOX 99, MATTESON, IL 60443-0099
(708) 747-5850
(708) 747-9991
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
036-072506
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31602670
BLUE SHIELD PROVIDER
IL
Enumeration date
05/24/2006
Last updated
11/25/2009
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