Individual
MAGGIE BUTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
401 S STATE ST, CHICAGO, IL 60605-1229
(333) 202-9082
Mailing address
700 GLOUCESTER DR, ELK GROVE VILLAGE, IL 60007-3318
(331) 202-9082
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096.002909
NON-MEDICARE
IL
Enumeration date
07/18/2018
Last updated
07/18/2018
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