Basic Information
Provider Information
NPI: 1437323714
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEVITZ
FirstName: SETH
MiddleName: PHILIP
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9650 GROSS POINT RD STE 2900
Address2:  
City: SKOKIE
State: IL
PostalCode: 600761214
CountryCode: US
TelephoneNumber: 8478667846
FaxNumber: 8477335060
Practice Location
Address1: 9650 GROSS POINT RD STE 2900
Address2:  
City: SKOKIE
State: IL
PostalCode: 60076
CountryCode: US
TelephoneNumber: 8478667846
FaxNumber: 8477335060
Other Information
ProviderEnumerationDate: 04/17/2008
LastUpdateDate: 10/16/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X036123624ILN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XS0106X036123624ILY Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery

No ID Information.


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