Individual
DR. ALFONSO E NOBLEZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
326 W 64TH ST, SUITE 208, CHICAGO, IL 60621-3114
(773) 962-3900
Mailing address
PO BOX 3603, OAK BROOK, IL 60522-3603
(773) 772-7858
(773) 276-6668
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036077887
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036077887
—
IL
01
—
12618087
CAQH
IL
01
—
F400234706
MEDICARE
IL
01
—
QMX000000107300
AETNA BETTER HEALTH
IL
Enumeration date
02/22/2006
Last updated
03/07/2023
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