Provider Demographics
NPI:1912157702
Name:BUTTS, LINDA S (DPT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:S
Last Name:BUTTS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1834 W NORTH AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-1312
Mailing Address - Country:US
Mailing Address - Phone:773-227-9150
Mailing Address - Fax:773-227-9160
Practice Address - Street 1:1834 W NORTH AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-1312
Practice Address - Country:US
Practice Address - Phone:773-227-9150
Practice Address - Fax:773-227-9160
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-29
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL070-016665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL070-016665OtherILLINOIS STATE LICENSE