Butler-Moo Young, Nichole M

Butler-Moo Young, Nichole M is an individual health care provider with primary practice located at 12150 S Harlem Ave , Palos Heights IL 60463-1435. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Butler-Moo Young, Nichole M can be contacted via phone (708) 388-0785.

Contact Information

Primary practice address
12150 S Harlem Ave Palos Heights IL 60463-1435
Phone: (708) 388-0785
Fax: (708) 388-1579
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036099421 Illinois

Profile Details

NPI number 1245222108
LBN Legal business name Butler-Moo Young, Nichole M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2005
Last updated Nov 19th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245222108 NPPES
Illinois MEDICAID 036099421

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