Individual
DR. SHIRAZ M BUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
120 E OGDEN AVE #222, HINSDALE, IL 60521
(630) 268-8850
(630) 268-1258
Mailing address
351 E 17TH ST, LOMBARD, IL 60148
(630) 268-8850
(630) 268-1258
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036100668
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036100668
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100668
—
IL
01
—
IL4966001
MEDICARE PTAN
IL
Enumeration date
08/31/2005
Last updated
07/26/2011
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