Provider Demographics
NPI:1215109384
Name:LEVY, CHRISTINE L (LCSW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:L
Last Name:LEVY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 N ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-2228
Mailing Address - Country:US
Mailing Address - Phone:708-383-0487
Mailing Address - Fax:708-383-0487
Practice Address - Street 1:542 N ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302-2228
Practice Address - Country:US
Practice Address - Phone:708-383-0487
Practice Address - Fax:708-383-0487
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-29
Last Update Date:2008-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-005791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical