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NPI Code Detail

MEDICARE: LIZANN NICOLE BUTLER

MEDICARE: LIZANN NICOLE BUTLER
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1275316085
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIZANN NICOLE BUTLER
Provider Business Mailing Address
First Line : 3770 176TH PL
Second Line :
City : COUNTRY CLUB HILLS
State : IL
Zip : 60478-4829
Country : US
Telephone Number : 630-901-3122
Fax Number :
Provider Business Practice Location Address
First Line : 2801 W HOWARD ST
Second Line :
City : CHICAGO
State : IL
Zip : 60645-1228
Country : US
Telephone Number : 773-305-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2023
Last Update Date : 08/15/2023

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Directions to “ LIZANN NICOLE BUTLER ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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