Basic Information
| Provider Information | |||||||||
| NPI: | 1689754822 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BUTLER | ||||||||
| FirstName: | LEON | ||||||||
| MiddleName: | EVERETT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 776351 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606776351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5025889490 | ||||||||
| FaxNumber: | 5022725116 | ||||||||
| Practice Location | |||||||||
| Address1: | 1930 BISHOP LN | ||||||||
| Address2: | STE. 1600 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402181921 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022725044 | ||||||||
| FaxNumber: | 5022725121 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2006 | ||||||||
| LastUpdateDate: | 01/13/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 4301038306 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 42017 | KY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | 01068145A | IN | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.