Active NPI
Richard G Noelte, ATC
- Athletic Trainer
- Libertyville, IL
National Provider Identifier
1205804895
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 716 Florsheim Dr
Libertyville, IL 60048-3757 - Phone
- (847) 918-9077
- NPI assigned
- Mar 9, 2006
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AL1792 | FL | |
| Athletic Trainer | 2255A2300X | 630039 | WI | |
| Athletic Trainer | 2255A2300X | IL | Primary |
Addresses
Primary practice location
716 Florsheim Dr
Libertyville, IL 60048-3757
Mailing address
31696 N Borre Dr
Lakemoor, IL 60051-2297
Phone (815) 271-5083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL1792 | FL | MD | Athletic Trainer |
| 096001346 | IL | MD | Athletic Trainer |
| 630039 | WI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1205804895",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31696 N BORRE DR",
"city": "LAKEMOOR",
"state": "IL",
"postal_code": "600512297",
"telephone_number": "815-271-5083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "716 FLORSHEIM DR",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600483757",
"telephone_number": "847-918-9077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOELTE",
"first_name": "RICHARD",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "FL",
"license": "AL1792",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "WI",
"license": "630039",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.