Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036072506 | IL |
Y | 2080P0205X | Pediatric Endocrinologist | 036-072506 | IL |
NPI | 1265431381 |
---|---|
Provider Name | Dr. Richard A Levy |
First Address | Chicago, IL 60625-3547 |
Second Address | Chicago, IL 60625-3547 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 07/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036072506 | (05) | IL |
31602670 | BCBSIL GROUP # (01) | IL |
D16695 | (02) | IL |