Provider Demographics
NPI:1033458294
Name:IM, NOAH (DC)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:
Last Name:IM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 E GOLF RD STE 950
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-5034
Mailing Address - Country:US
Mailing Address - Phone:224-864-1215
Mailing Address - Fax:
Practice Address - Street 1:1900 E GOLF RD STE 950
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5034
Practice Address - Country:US
Practice Address - Phone:224-864-1215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-07
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012352111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor