Individual
MRS. JESSICA E. RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1870 SILVER CROSS BLVD, SUITE 200, NEW LENOX, IL 60451-8639
(815) 462-3474
(630) 794-8615
Mailing address
550 W OGDEN AVE, HINSDALE, IL 60521-3186
(630) 323-6116
(630) 794-8615
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085004671
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085004617
PHYSICIAN ASSISTANT LICENSE
IL
Enumeration date
03/21/2013
Last updated
01/18/2022
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