Alberto Butalid, MD
Individual provider Active NPI Internal Medicine Physician · Carlyle, IL
NPI 1023070752 · NPPES record last updated Mar 9, 2012
Key facts
- NPI
- 1023070752
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 036070872 (IL)
- Practice address
- 14505 State Route 127
Carlyle, IL 62231-6485 - Phone
- (618) 594-8924
- Fax
- (618) 594-7918
- NPI assigned
- Apr 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050914000693 | IL | Practitioner - Internal Medicine | 9739112327 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| HSHS Medical Group Inc | Past |
Accepting new patients |
Interoperability endpoints
- alberto.butalid@ccrh.directbygreenway.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 036070872 | IL | Yes |
Addresses
Primary practice location
14505 State Route 127
Carlyle, IL 62231-6485
Mailing address
14505 State Route 127
Carlyle, IL 62231-6485
Phone (618) 594-8924
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD8320 | Other | IL | RR MEDICARE GROUP |
| 208959 | Other | IL | GROUP |
| 036080872 | Medicaid | IL |
Other providers in Carlyle, IL
- Angela Becker
- Teri Joyce Berry
- Milinda A Birkner
- Bloom With Hope PLLC
- Amanda Beth Boeing
- Brynn Byrd
- Carlyle Cu SCH Dist 1
- Carlyle Healthcare & Senior Living, LLC
- Carlyle Healthcare Center
- Carlyle Healthcare Center Inc.
All providers in Carlyle, IL · Internal Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.