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Individual
JOSE RODRIGO NINO
Active
Individual
JOSE RODRIGO NINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180-005762
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01635496
BCBS PPO PROVIDER #
IL
01
—
258267
COMPSYCH PROVIDER NUMBER
IL
Enumeration date
04/12/2006
Last updated
12/03/2014
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