Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036082360 | IL |
N | 207VG0400X | Gynecologist | 036082360 | IL |
NPI | 1700998366 |
---|---|
Provider Name | Dr. Michael Brendan Noone |
First Address | Park Ridge, IL 60068-1186 |
Second Address | Park Ridge, IL 60068 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 09/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036082360 | (05) | IL |