Individual
JOSEPH ROUDEZ III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
555 HICKOK AVE, UNIVERSITY PARK, IL 60484-3037
(708) 323-9668
Mailing address
607 HICKOK AVE, UNIVERSITY PK, IL 60484-3020
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
R3204856221
IL
Other
Enumeration date
02/08/2017
Last updated
02/08/2017
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