Individual
PAMELA TERESA VERGARA-RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2020 W HARRISON ST, CHICAGO, IL 60612-3741
(312) 572-4753
(312) 572-4597
Mailing address
865 W LILL AVE APT 3, CHICAGO, IL 60614-2309
(312) 371-2026
(773) 404-0026
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-111630
IL
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
036-111630
IL
2084P0800X
Psychiatry Physician
Primary
036-11630
IL
Other
Enumeration date
01/23/2007
Last updated
05/04/2021
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