Healthcare Provider Details

I. General information

NPI: 1073714630
Provider Name (Legal Business Name): DIANE MARIE BUTTERFIELD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N HIGHLAND AVE
AURORA IL
60506-3814
US

IV. Provider business mailing address

954 DAKOTA CIR
NAPERVILLE IL
60563-9307
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-2532
  • Fax: 630-978-2709
Mailing address:
  • Phone: 630-717-7867
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-080147
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: