Provider Demographics
NPI:1588287718
Name:BUTLER-SOLOMON, DOROTHY (MS,QMHP)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:BUTLER-SOLOMON
Suffix:
Gender:F
Credentials:MS,QMHP
Other - Prefix:
Other - First Name:DOROTHY
Other - Middle Name:
Other - Last Name:BUTLER-SOLOMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,QMHP
Mailing Address - Street 1:4801 SOUTHWICK DR STE 300
Mailing Address - Street 2:
Mailing Address - City:MATTESON
Mailing Address - State:IL
Mailing Address - Zip Code:60443-2279
Mailing Address - Country:US
Mailing Address - Phone:708-747-2655
Mailing Address - Fax:708-747-2859
Practice Address - Street 1:2431 BETHANY RD STE E
Practice Address - Street 2:
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3136
Practice Address - Country:US
Practice Address - Phone:708-917-2871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health