Individual
MS. KENYATTA BUTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPECIALIST
Contact information
Practice address
8100 S STONY ISLAND AVE, CHICAGO, IL 60617-1734
(312) 623-9966
Mailing address
5225 N KENMORE AVE, CHICAGO, IL 60640-2445
(773) 931-8963
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
IL
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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