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General NPI Number Information
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NPI Number | 1073629481
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Entity Type | Individual
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Provider Name | NICOLE NOELLE KREPS AUD., CCC-A
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Gender | Female
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 12/07/2016
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Provider Practice Location Address
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Address Line | 10409 S ROBERTS RD SUITE 306
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City | PALOS HILLS
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State | IL
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Zip | 60465-1931
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Country | US
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Telephone | 630-323-5256
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Fax |
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Provider Business Mailing Address
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Address Line | 10409 S ROBERTS RD
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City | PALOS HILLS
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State | IL
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Zip | 60465-1931
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Country | US
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Telephone | 708-212-1769
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 147-000893
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AY 1507
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License Number State | FL
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