Provider Demographics
NPI:1912544792
Name:RAY, NOELLE (MSN, AGACNP)
Entity Type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:RAY
Suffix:
Gender:F
Credentials:MSN, AGACNP
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:
Other - Last Name:CURRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:447 DELLES RD
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4831
Mailing Address - Country:US
Mailing Address - Phone:630-244-9200
Mailing Address - Fax:
Practice Address - Street 1:550 W OGDEN AVE STE 100
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-0528
Practice Address - Country:US
Practice Address - Phone:630-323-6116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041421218163W00000X
IL209020169363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse