Individual
MARIE RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4318 S STATE ST, CHICAGO, IL 60609-3701
(773) 285-9304
Mailing address
PO BOX 746721, ATLANTA, GA 30374-6721
(733) 521-5157
(312) 929-0373
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
71005662
IN
363LG0600X
Gerontology Nurse Practitioner
Primary
209.025497
IL
363LG0600X
Gerontology Nurse Practitioner
71005662
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
71005662
LICENSE
IN
Enumeration date
06/24/2011
Last updated
02/18/2025
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