Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 038.013276 | IL |
NPI | 1003386194 |
---|---|
Provider Name | Dr. Nathan Paul Noblet |
First Address | Glenview, IL 60025-6921 |
Second Address | Glenview, IL 60025-6921 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2018 |
Last Update Date | 30/11/2018 |