Individual
MARK LEVINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
444 W JACKSON BLVD, CHICAGO, IL 60606-6923
(312) 627-0444
Mailing address
444 W JACKSON BLVD, CHICAGO, IL 60606-6923
(312) 627-0444
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006471
IL
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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