Individual
JACK RODRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6072 BRYNWOOD DR, ROCKFORD, IL 61114-5829
(815) 636-0825
(815) 636-2271
Mailing address
PO BOX 15105, LOVES PARK, IL 61132-5105
(815) 654-7772
(815) 654-7009
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
01/17/2006
Last updated
07/16/2007
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