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Individual

RENI S. BUTLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1800 HOLLISTER DR, SUITE G-18, LIBERTYVILLE, IL 60048-5264
(847) 918-1462
(847) 968-4311
Mailing address
1800 HOLLISTER DR, SUITE G-18, LIBERTYVILLE, IL 60048-5264
(847) 918-1462
(847) 968-4311

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036096102
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036-096102
STATE LICENSE
IL
01
202926
GROUP PTAN
IL
01
212545
GROUP PTAN
IL
Enumeration date
07/29/2005
Last updated
09/02/2009
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