Healthcare Provider Details

I. General information

NPI: 1275481103
Provider Name (Legal Business Name): NOAH WEBB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 N WOLCOTT AVE
CHICAGO IL
60613-2411
US

IV. Provider business mailing address

4001 N WOLCOTT AVE
CHICAGO IL
60613-2411
US

V. Phone/Fax

Practice location:
  • Phone: 773-789-9775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number178022771
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: