Provider Demographics
NPI:1669444501
Name:LEVI, LINDA S (MA)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:S
Last Name:LEVI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 N NORTHWEST HWY
Mailing Address - Street 2:SUITE 111A
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-1444
Mailing Address - Country:US
Mailing Address - Phone:847-824-9590
Mailing Address - Fax:847-559-0124
Practice Address - Street 1:1580 N NORTHWEST HWY
Practice Address - Street 2:SUITE 111A
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-1444
Practice Address - Country:US
Practice Address - Phone:847-824-9590
Practice Address - Fax:847-559-0124
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health