Provider Demographics
NPI:1528816188
Name:LEVIN, ZACHARY (PSYD)
Entity type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:LEVIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1249 W MELROSE ST UNIT 1E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-1279
Mailing Address - Country:US
Mailing Address - Phone:847-404-7292
Mailing Address - Fax:
Practice Address - Street 1:1249 W MELROSE ST UNIT 1E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-1279
Practice Address - Country:US
Practice Address - Phone:847-404-7292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist