Individual
CAROLINE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
4211 N CICERO AVE, CHICAGO, IL 60641-1651
(773) 794-1000
Mailing address
4431 N MOBILE AVE, CHICAGO, IL 60630-3019
(408) 607-5081
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209014514
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209014514
APN LICENSE NUMBER
IL
Enumeration date
11/04/2016
Last updated
11/04/2016
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