Individual
DR. NICHOLE M BUTLER-MOO YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7411 LAKE ST STE 1120, RIVER FOREST, IL 60305-1882
(708) 763-2328
(708) 345-9984
Mailing address
7411 LAKE ST STE 1120, RIVER FOREST, IL 60305-1882
(708) 763-2328
(708) 345-9984
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036099421
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036099421
—
IL
Enumeration date
08/17/2005
Last updated
12/03/2025
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