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NPI Code Detail

MEDICARE: AMANDA NOEL MICH MS

MEDICARE: AMANDA NOEL MICH MS
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
1235Z00000XSpeech-Language Pathologist

General Provider Information

NPI Number : 1740938729
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA NOEL MICH MS
Provider Business Mailing Address
First Line : 1903 W ADDISON ST APT 3
Second Line :
City : CHICAGO
State : IL
Zip : 60613-3563
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 633 W ADDISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60613-4981
Country : US
Telephone Number : 312-458-9865
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2022
Last Update Date : 03/17/2022

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Directions to “ AMANDA NOEL MICH MS” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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