Provider Demographics
NPI:1417998907
Name:BUTLER, CHRISTINA LEE (CNM)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LEE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S WILKE RD
Mailing Address - Street 2:600
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1533
Mailing Address - Country:US
Mailing Address - Phone:847-259-4122
Mailing Address - Fax:847-259-1571
Practice Address - Street 1:121 S WILKE RD
Practice Address - Street 2:600
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1533
Practice Address - Country:US
Practice Address - Phone:847-259-4122
Practice Address - Fax:847-259-1571
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209-004437367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife