Provider Demographics
NPI:1154145001
Name:BIDDLE, LEVITE JUDAH (PARAMEDIC)
Entity type:Individual
Prefix:
First Name:LEVITE
Middle Name:JUDAH
Last Name:BIDDLE
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 HIGH POINT LN
Mailing Address - Street 2:
Mailing Address - City:DONGOLA
Mailing Address - State:IL
Mailing Address - Zip Code:62926-1024
Mailing Address - Country:US
Mailing Address - Phone:618-306-3896
Mailing Address - Fax:
Practice Address - Street 1:3224 S PARK AVE
Practice Address - Street 2:
Practice Address - City:HERRIN
Practice Address - State:IL
Practice Address - Zip Code:62948-3715
Practice Address - Country:US
Practice Address - Phone:618-740-0949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL06052987207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services