Individual
JOSE MIGUEL RODRIGUEZ OQUENDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
505 W BELMONT AVE APT 5M, CHICAGO, IL 60657-6824
(773) 387-2619
Mailing address
505 W BELMONT AVE APT 5M, CHICAGO, IL 60657-6824
(773) 387-2619
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17-394
IL
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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