Provider Demographics
NPI:1215614904
Name:NOBLE, CREE (MED)
Entity type:Individual
Prefix:
First Name:CREE
Middle Name:
Last Name:NOBLE
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 ROSELYN DR
Mailing Address - Street 2:
Mailing Address - City:RANTOUL
Mailing Address - State:IL
Mailing Address - Zip Code:61866-1661
Mailing Address - Country:US
Mailing Address - Phone:217-390-7607
Mailing Address - Fax:
Practice Address - Street 1:4028 W IRVING PARK RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60641-2925
Practice Address - Country:US
Practice Address - Phone:773-850-9046
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101200000XBehavioral Health & Social Service ProvidersDrama Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor