Individual
NYDIA I RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3305 N FINNELL AVE, PEORIA, IL 61604
(309) 427-9059
Mailing address
3305 N FINNELL AVE, PEORIA, IL 61604-1917
(309) 427-9059
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R36262986616
DRIVERS LICENSE
IL
Enumeration date
07/03/2017
Last updated
07/21/2022
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