Individual
COURTNEY RODICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, ACNS-BC
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 370-8816
Mailing address
8000 W TUSCARORA RD, MAPLETON, IL 61547-9483
(309) 370-8816
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-012789
IL
364SA2200X
Adult Health Clinical Nurse Specialist
209012789
IL
Other
Enumeration date
05/05/2015
Last updated
08/24/2017
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