Provider Demographics
NPI:1831403849
Name:LEVIN, SHANI L (MA)
Entity type:Individual
Prefix:MS
First Name:SHANI
Middle Name:L
Last Name:LEVIN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N FAIRWAY DR
Mailing Address - Street 2:SUITE 208
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-1861
Mailing Address - Country:US
Mailing Address - Phone:847-996-6666
Mailing Address - Fax:
Practice Address - Street 1:200 N FAIRWAY DR
Practice Address - Street 2:SUITE 208
Practice Address - City:VERNON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60061-1861
Practice Address - Country:US
Practice Address - Phone:847-996-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-02
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL242.001591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist