Provider Demographics
NPI:1669043592
Name:LEVINE, DEBORAH
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:LEVINE
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 1:1060 HAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROUND LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60073-3751
Mailing Address - Country:US
Mailing Address - Phone:847-736-0800
Mailing Address - Fax:
Practice Address - Street 1:977 LAKEVIEW PKWY STE 150
Practice Address - Street 2:
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1476
Practice Address - Country:US
Practice Address - Phone:847-438-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker