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NPI Code Detail

MEDICARE: KATHERINE NOLL PH.D.

MEDICARE: KATHERINE NOLL PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical PsychologistIL

General Provider Information

NPI Number : 1124082771
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE NOLL PH.D.
Provider Business Mailing Address
First Line : 1725 S NAPERVILLE RD
Second Line : SUITE 206
City : WHEATON
State : IL
Zip : 60187-8155
Country : US
Telephone Number : 630-653-6441
Fax Number : 630-653-8409
Provider Business Practice Location Address
First Line : 1725 S NAPERVILLE RD
Second Line : SUITE 206
City : WHEATON
State : IL
Zip : 60187-8155
Country : US
Telephone Number : 630-653-6441
Fax Number : 630-653-8409
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 07/08/2007

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