Provider Demographics
NPI:1093480501
Name:LEVY, BIANCA
Entity type:Individual
Prefix:
First Name:BIANCA
Middle Name:
Last Name:LEVY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 N HUDSON AVE UNIT 410
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-6700
Mailing Address - Country:US
Mailing Address - Phone:914-355-0726
Mailing Address - Fax:
Practice Address - Street 1:750 N HUDSON AVE UNIT 410
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-6700
Practice Address - Country:US
Practice Address - Phone:914-355-0726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-16
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET003321235Z00000X
TX119438235Z00000X
GASLP012057235Z00000X
IL146.018237235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist