Provider Demographics
NPI:1831725886
Name:BUTT, ANAM
Entity type:Individual
Prefix:
First Name:ANAM
Middle Name:
Last Name:BUTT
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 1:565 KINGMAN LN
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-3237
Mailing Address - Country:US
Mailing Address - Phone:630-286-3355
Mailing Address - Fax:
Practice Address - Street 1:11330 S HARLEM AVE STE 4
Practice Address - Street 2:
Practice Address - City:WORTH
Practice Address - State:IL
Practice Address - Zip Code:60482-2060
Practice Address - Country:US
Practice Address - Phone:630-286-3355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1920672471S1302X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography