Individual
AMY KATHERINE RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
719 LAKE ST, OAK PARK, IL 60301-1406
(708) 386-3200
Mailing address
4420 PRAIRIE AVE, BROOKFIELD, IL 60513-2502
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.027947
IL
122300000X
Dentist
60722
KS
Other
Enumeration date
06/02/2009
Last updated
02/20/2014
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