Provider Demographics
NPI:1134389901
Name:LEV, WENDI (LCSW, ACSW, CADC)
Entity type:Individual
Prefix:
First Name:WENDI
Middle Name:
Last Name:LEV
Suffix:
Gender:F
Credentials:LCSW, ACSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N CANAL ST
Mailing Address - Street 2:905
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1549
Mailing Address - Country:US
Mailing Address - Phone:312-203-2979
Mailing Address - Fax:847-432-1016
Practice Address - Street 1:165 N CANAL ST
Practice Address - Street 2:905
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-1549
Practice Address - Country:US
Practice Address - Phone:312-203-2979
Practice Address - Fax:847-432-1016
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490081691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical