Individual
MS. JOANNE CARBONELL-RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DT
Contact information
Practice address
3040 N WILTON AVE, 2ND FL, CHICAGO, IL 60657-4424
(773) 296-7687
(773) 296-7281
Mailing address
2800 W JEROME ST, CHICAGO, IL 60645-1231
(773) 508-0329
(773) 274-8685
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JC54880398P
EARLY INTERVENTION PROVID
IL
Enumeration date
02/15/2007
Last updated
07/08/2007
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