Individual
MISS JESSICA ALICIA RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
715 LAKE ST STE 806, OAK PARK, IL 60301-1417
(773) 312-3612
Mailing address
3145 N NEWCASTLE AVE, CHICAGO, IL 60634-4624
(773) 390-1997
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178018894
IL
103TC0700X
Clinical Psychologist
103TC0700X
IL
Other
Enumeration date
01/28/2022
Last updated
04/20/2023
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