Individual
EMILY C RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
375 N WALL ST, SUITE P530, KANKAKEE, IL 60901-3483
(815) 937-4006
(815) 937-3850
Mailing address
375 N WALL ST, SUITE P530, KANKAKEE, IL 60901-3483
(815) 937-4006
(815) 937-3850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085003676
IL
363AM0700X
Medical Physician Assistant
Primary
085003676
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085003676
LICENSE
IL
Enumeration date
01/29/2010
Last updated
11/06/2024
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