Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 036081557 | IL |
N | 207Q00000X | Family Doctor | 036081557 | IL |
NPI | 1003849563 |
---|---|
Provider Name | Joseph H Levenstein |
First Address | Harvard, IL 60033-1821 |
Second Address | Harvard, IL 60033-1821 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 30/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036081557 | (05) | IL |
1003849563 | (05) | WI |
F36002 | (02) | IL |
P000760377CG6042 | RAILROAD MEDICARE (01) | IL |