Provider Demographics
NPI:1356716591
Name:ARNOLD, NONI (NEMT)
Entity type:Individual
Prefix:
First Name:NONI
Middle Name:
Last Name:ARNOLD
Suffix:
Gender:F
Credentials:NEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13246 S LANGLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60827-1336
Mailing Address - Country:US
Mailing Address - Phone:312-730-3618
Mailing Address - Fax:
Practice Address - Street 1:13246 S LANGLEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60827-1336
Practice Address - Country:US
Practice Address - Phone:312-730-3618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-13
Last Update Date:2015-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X
IL528345-01172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No172V00000XOther Service ProvidersCommunity Health Worker