Provider Demographics
NPI:1821422635
Name:LEVY, JOSHUA DAVID (PHD)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DAVID
Last Name:LEVY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NORTH WACKER DRIVE
Mailing Address - Street 2:SUITE 1442
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606
Mailing Address - Country:US
Mailing Address - Phone:312-321-6047
Mailing Address - Fax:312-372-4732
Practice Address - Street 1:20 NORTH WACKER DRIVE
Practice Address - Street 2:SUITE 1442
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606
Practice Address - Country:US
Practice Address - Phone:312-321-6047
Practice Address - Fax:312-372-4732
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166-00514106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist