Butler-Moo Young, Nichole M

Butler-Moo Young, Nichole M is an individual health care provider with primary practice located at 7411 Lake St Ste 1120 , River Forest IL 60305-1882. 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) 763-2328.

Contact Information

Primary practice address
7411 Lake St Ste 1120 River Forest IL 60305-1882
Phone: (708) 763-2328
Fax: (708) 345-9984
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 Dec 3rd, 2025 - about last year

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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