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Individual

DR. JUANITA RODRIGUEZ AGUILA-CORRALES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1 ILLINI DRIVE, PEORIA, IL 61605-2576
(309) 671-8504
(309) 671-8513
Mailing address
530 N.E. GLEN OAK, PEORIA, IL 61637-0001
(773) 484-1000
(309) 655-2974

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036114194
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036-114194
STATE LICENSE
IL
Enumeration date
06/25/2007
Last updated
07/20/2021
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