Provider Demographics
NPI:1356895627
Name:LEVINE, CAITLIN SLOAN (PA)
Entity type:Individual
Prefix:MS
First Name:CAITLIN
Middle Name:SLOAN
Last Name:LEVINE
Suffix:
Gender:F
Credentials:PA
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Other - Credentials:
Mailing Address - Street 1:1750 W. HARRISON ST
Mailing Address - Street 2:SUITE 108 KELLOGG
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3825
Mailing Address - Country:US
Mailing Address - Phone:312-947-0229
Mailing Address - Fax:312-942-4021
Practice Address - Street 1:1653 W CONGRESS PKWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3833
Practice Address - Country:US
Practice Address - Phone:312-947-0229
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL085-006147363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant