A. Gwendolyn Noble, M.D., PH.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036-080087 Issued in IL

Practice address

7638 W North Ave
Elmwood Park, IL 60707-4157

Phone

(708) 452-4257

Fax

(708) 452-4283

NPI assigned

Jan 2, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Alma Gwendolyn Noble Other name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1790763670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7638 W NORTH AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074157",
            "telephone_number": "708-452-4257",
            "fax_number": "708-452-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7638 W NORTH AVE",
            "city": "ELMWOOD PARK",
            "state": "IL",
            "postal_code": "607074157",
            "telephone_number": "708-452-4257",
            "fax_number": "708-452-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "A.",
        "middle_name": "GWENDOLYN",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-02",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036-080087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363842073",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALMA",
            "last_name": "NOBLE",
            "middle_name": "GWENDOLYN",
            "credential": "M.D., PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Teresa Neeliyara, PHD CLINICAL PSYCHOL
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• Nexus at Elmwood Park, LLC
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• Christina Nguyen
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• Oko Medical Eyecare
• John Albert Orlando, DC
• Joseph F Orrico Jr., D.D.S
• Rosa Ortiz, MSW, QMHP

• Ophthalmology Physician in Elmwood Park, IL
• Providers in Elmwood Park, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.