Provider Demographics
NPI:1891420691
Name:BUTLER-WINTERS, TYNEER
Entity Type:Individual
Prefix:
First Name:TYNEER
Middle Name:
Last Name:BUTLER-WINTERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3956 172ND ST
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-4638
Mailing Address - Country:US
Mailing Address - Phone:773-957-8483
Mailing Address - Fax:
Practice Address - Street 1:9631 S. CICERO AVE
Practice Address - Street 2:#1211
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453
Practice Address - Country:US
Practice Address - Phone:773-234-4214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor