Individual provider Active NPI

Victoria A Butur, FNP-C

  • Family Nurse Practitioner
  • McHenry, IL
National Provider Identifier
1861063992
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209.023550 Issued in IL
Practice address
200 Donegal CT
McHenry, IL 60050-8063
Phone
(617) 505-1520
Fax
(617) 928-8401
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 296031 AZ
Family Nurse Practitioner 363LF0000X 209.023550 IL Primary

Addresses

Primary practice location

200 Donegal CT
McHenry, IL 60050-8063

Mailing address

200 Donegal CT
McHenry, IL 60050-8063
Phone (847) 708-5728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220510001021 IL Practitioner - Nurse Practitioner 4284011438 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Shore Primary Care S.C.Group PAC ID 6204925415, 8 clinicians

Practice addresses (Care Compare)

1900 Hollister Dr
Suite 250
Libertyville, IL 60048-5249
Phone (847) 573-9663

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
296031AZMDFamily Nurse Practitioner
209.023550ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Form Health Associates Ma, P.C. CurrentSince Oct 31, 2023 Accepting new patients
North Shore Primary Care S.C. CurrentSince Apr 1, 2022 Accepting new patients

Locations

125 S Wacker Dr
Ste 300
Chicago, IL 60606
Phone (254) 760-0283

1900 Hollister Dr
Ste 250
Libertyville, IL 60048
Phone (847) 549-0055

109 State St
Ste 5
Boston, MA 02109

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1861063992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DONEGAL CT",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508063",
            "telephone_number": "847-708-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 DONEGAL CT",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600508063",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUTUR",
        "first_name": "VICTORIA",
        "middle_name": "A",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-09",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "296031",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.023550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, IL

Sources for this page

Verify at the official NPI Registry.