Provider Demographics
NPI:1194209718
Name:WALLIN-SANCHEZ, NOELLE HOPE (RN, CRNA)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:HOPE
Last Name:WALLIN-SANCHEZ
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:HOPE
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:71 W HUBBARD ST APT 3311
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-4621
Mailing Address - Country:US
Mailing Address - Phone:574-253-1827
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1443
Practice Address - Country:US
Practice Address - Phone:574-253-1827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122699367500000X
IL209018577367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered