Provider Demographics
NPI:1033166483
Name:LEVY, BARRY E (MD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:E
Last Name:LEVY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10640 W 165TH STREET
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-5653
Mailing Address - Country:US
Mailing Address - Phone:708-364-0261
Mailing Address - Fax:708-364-6019
Practice Address - Street 1:10640 W 165TH STREET
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-5653
Practice Address - Country:US
Practice Address - Phone:708-364-0261
Practice Address - Fax:708-364-6019
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL3360620372084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC39374Medicare UPIN
ILP0026050Medicare PIN
ILK16039Medicare PIN
ILK26755Medicare PIN
IL211335Medicare PIN
IL208306Medicare PIN
IL206975Medicare PIN
ILK16518Medicare PIN
IL215683Medicare PIN
ILK11991Medicare PIN
IL215684Medicare PIN
ILP00280726Medicare PIN
ILK15002Medicare PIN