Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 036.156437 | IL |
NPI | 1083076053 |
---|---|
Provider Name | Alexander Butler |
First Address | Chicago, IL 60612-4861 |
Second Address | Chicago, IL 60612-4861 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2016 |
Last Update Date | 21/07/2021 |