Provider Demographics
NPI:1427387950
Name:NOONAN, REBECCA ANN
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:NOONAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 AMLI LANE
Mailing Address - Street 2:#2617
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502
Mailing Address - Country:US
Mailing Address - Phone:630-291-5248
Mailing Address - Fax:
Practice Address - Street 1:2805 AMLI LN
Practice Address - Street 2:#2617
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-8819
Practice Address - Country:US
Practice Address - Phone:630-291-5248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.009277235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist