Provider Demographics
NPI:1336863505
Name:LEVY, CAROLINE EMMA (OTD, OTR/L)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:EMMA
Last Name:LEVY
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 W WALTON ST APT 3B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-4993
Mailing Address - Country:US
Mailing Address - Phone:312-343-6113
Mailing Address - Fax:
Practice Address - Street 1:2004 W WALTON ST APT 3B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-4993
Practice Address - Country:US
Practice Address - Phone:312-343-6113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist