Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 34.009224 | OH |
NPI | 1003083650 |
---|---|
Provider Name | Ingrid Rodriguez |
First Address | Oakbrook Terrace, IL 60181-4822 |
Second Address | Sylvania, OH 43560-2168 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/05/2008 |
Last Update Date | 14/05/2008 |