Provider Demographics
NPI:1073753646
Name:LEVIN, ADAM A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:A
Last Name:LEVIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 LAKE COOK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-4976
Mailing Address - Country:US
Mailing Address - Phone:847-267-0001
Mailing Address - Fax:
Practice Address - Street 1:770 LAKE COOK RD STE 250
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4976
Practice Address - Country:US
Practice Address - Phone:847-267-0001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071006970103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical