MEDICARE: CHRISTINA LEE BUTLER CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	209-004437	IL

General Provider Information

NPI Number	:	1417998907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA LEE BUTLER CNM

Provider Business Mailing Address
First Line	:	121 S WILKE RD
Second Line	:	600
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1533
Country	:	US
Telephone Number	:	847-259-4122
Fax Number	:	847-259-1571

Provider Business Practice Location Address
First Line	:	121 S WILKE RD
Second Line	:	600
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-1533
Country	:	US
Telephone Number	:	847-259-4122
Fax Number	:	847-259-1571

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	07/08/2007

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