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General NPI Number Information
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NPI Number | 1326013236
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Entity Type | Individual
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Provider Name | ALFONSO E NOBLEZA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/22/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 326 W 64TH ST SUITE 208
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City | CHICAGO
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State | IL
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Zip | 60621-3114
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Country | US
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Telephone | 773-962-3900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3603
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City | OAK BROOK
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State | IL
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Zip | 60522-3603
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Country | US
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Telephone | 773-772-7858
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Fax | 773-276-6668
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036077887
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License Number State | IL
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