Provider Demographics
NPI:1861063992
Name:BUTUR, VICTORIA A (FNP-C)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:A
Last Name:BUTUR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 DONEGAL CT
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8063
Mailing Address - Country:US
Mailing Address - Phone:847-708-5728
Mailing Address - Fax:
Practice Address - Street 1:200 DONEGAL CT
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8063
Practice Address - Country:US
Practice Address - Phone:617-505-1520
Practice Address - Fax:617-928-8401
Is Sole Proprietor?:No
Enumeration Date:2021-07-09
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ296031363LF0000X
IL209.023550363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily