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General NPI Number Information
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NPI Number | 1902815574
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Entity Type | Individual
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Provider Name | ROBERT J. NOONE PH.D
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 820 DAVIS ST SUITE 504
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City | EVANSTON
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State | IL
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Zip | 60201-4431
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Country | US
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Telephone | 847-507-3460
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Fax |
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Provider Business Mailing Address
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Address Line | 820 DAVIS ST SUITE 504
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City | EVANSTON
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State | IL
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Zip | 60201-4431
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Country | US
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Telephone | 847-507-3460
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149004166
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 149004166
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License Number State | IL
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