Provider Demographics
NPI:1699335018
Name:LEVY ZIMMERMAN, DINA (NP-C)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:LEVY ZIMMERMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:LEVY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2843 W SHERWIN AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645
Mailing Address - Country:US
Mailing Address - Phone:773-837-4634
Mailing Address - Fax:
Practice Address - Street 1:6374 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1275
Practice Address - Country:US
Practice Address - Phone:773-837-4634
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209.018631363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily