Provider Demographics
NPI:1780650804
Name:BUTTZ, DARIN JOHN (MS, ATC)
Entity Type:Individual
Prefix:MR
First Name:DARIN
Middle Name:JOHN
Last Name:BUTTZ
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 ROSEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MT ZION
Mailing Address - State:IL
Mailing Address - Zip Code:62549-1046
Mailing Address - Country:US
Mailing Address - Phone:217-864-6769
Mailing Address - Fax:
Practice Address - Street 1:102 W KENWOOD AVE
Practice Address - Street 2:DECATUR MEMORIAL HOPSPITAL: KENWOOD MEDICAL CENTER
Practice Address - City:DACATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1046
Practice Address - Country:US
Practice Address - Phone:217-876-2690
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer