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General NPI Number Information
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NPI Number | 1417141235
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Entity Type | Organization
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Legal Business Name | DAVID N BUTLER MD SC
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Dates
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Enumeration Date | 09/05/2007
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Last Update Date | 05/03/2012
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Provider Practice Location Address
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Address Line | 2001 S CALIFORNIA AVE SUITE #101
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City | CHICAGO
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State | IL
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Zip | 60608-2405
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Country | US
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Telephone | 773-254-5350
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Fax | 773-254-5353
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Provider Business Mailing Address
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Address Line | PO BOX 805686
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City | CHICAGO
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State | IL
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Zip | 60680-4118
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Country | US
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Telephone | 773-254-5350
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Fax | 773-254-5353
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID N BUTLER
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Credential | M.D.
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Telephone | 773-254-5350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036086271
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License Number State | IL
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