Provider Demographics
NPI:1700876307
Name:BUTTIN, BARBARA M (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:BUTTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CANCER TREATMENT CENTERS OF AMERICA
Mailing Address - Street 2:2361 PAYSPHERE CIRCLE
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674
Mailing Address - Country:US
Mailing Address - Phone:800-322-9183
Mailing Address - Fax:630-933-4959
Practice Address - Street 1:CANCER TREATMENT CENTERS OF AMERICA
Practice Address - Street 2:2520 ELISHA AVENUE
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099
Practice Address - Country:US
Practice Address - Phone:800-322-9183
Practice Address - Fax:630-933-4959
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036114077207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01090225OtherRAILROAD MEDICARE PTAN (INDIVIDUAL)
IL036114077Medicaid
ILCA4748OtherRAILROAD MEDICARE PTAN (GROUP)
IL206147OtherMEDICARE PTAN (GROUP)
IL206147091OtherMEDICARE PTAN (INDIVIDUAL)
ILP01090225OtherRAILROAD MEDICARE PTAN (INDIVIDUAL)
ILI42447Medicare UPIN