Provider Demographics
NPI:1437341567
Name:NOBLE, JILL SHANNON I (DC)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:SHANNON
Last Name:NOBLE
Suffix:I
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CARPENTERSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60110-2844
Mailing Address - Country:US
Mailing Address - Phone:847-426-2121
Mailing Address - Fax:847-426-2136
Practice Address - Street 1:324 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARPENTERSVILLE
Practice Address - State:IL
Practice Address - Zip Code:60110-2844
Practice Address - Country:US
Practice Address - Phone:847-426-2121
Practice Address - Fax:847-426-2136
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-13
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008244111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor