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Individual

MR. GREGORY A RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
12410 S VAN DYKE RD, PLAINFIELD, IL 60585-2520
(800) 361-6880
(708) 845-5505
Mailing address
15127 S 73RD AVE, SUITE G, ORLAND PARK, IL 60462-4398
(708) 845-5500
(708) 845-5505

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
180.007632
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09932036
BCBS PROVIDER NUMBER
IL
Enumeration date
03/16/2007
Last updated
12/17/2010
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