Provider Demographics
NPI:1811930811
Name:LEVIN, KAREN FAITH (MD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:FAITH
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 PHEASANT LN
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3636
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 SW 10TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604
Practice Address - Country:US
Practice Address - Phone:785-354-0578
Practice Address - Fax:785-354-0520
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-084202174400000X
IL036.0842022084N0400X
KS04-385372084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036084202Medicaid
IL340810Medicare ID - Type Unspecified
ILF76322Medicare UPIN