Kendra M. Butz, LPN

Individual provider Active NPI Licensed Practical Nurse · Morris, IL

NPI 1063733186 · NPPES record last updated Jun 14, 2010

Key facts

NPI
1063733186
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
043085069 (IL)
Practice address
1401 Lakewood Dr
Suite a
Morris, IL 60450-3352
Phone
(815) 942-6323
Fax
(815) 941-0308
NPI assigned
Jun 14, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
043085069ILMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 043085069 IL Yes

Addresses

Primary practice location

1401 Lakewood Dr
Suite a
Morris, IL 60450-3352

Mailing address

1401 Lakewood Dr
Suite a
Morris, IL 60450-3352
Phone (815) 942-6323

Other providers in Morris, IL

All providers in Morris, IL · Licensed Practical Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.