Provider Demographics
NPI:1801452370
Name:BUTLER, ANNA GEORGE (DC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:GEORGE
Last Name:BUTLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:ALEXANDRA
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:1457 N HALSTED ST APT 713
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60642-2655
Mailing Address - Country:US
Mailing Address - Phone:318-512-9475
Mailing Address - Fax:
Practice Address - Street 1:910 DAVIS ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3608
Practice Address - Country:US
Practice Address - Phone:847-728-5433
Practice Address - Fax:847-728-5437
Is Sole Proprietor?:No
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.013350111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor