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Individual

DANIELLE SUZANNE RODRIGUEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
1221 E STATE ST, ROCKFORD, IL 61104-2231
(815) 972-1000
(815) 972-1086
Mailing address
1601 PARKVIEW AVENUE, CREDENTIALING S200C, ROCKFORD, IL 61107
(815) 395-5861
(815) 395-5575

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
227378
IL
363LF0000X
Family Nurse Practitioner
Primary
209025968
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209025968
IL

Other

Enumeration date
07/17/2020
Last updated
10/31/2023
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