Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174N00000X | Lactation Consultant | 199-15951 |
NPI | 1083985725 |
---|---|
Provider Name | Mrs. Maria C. Rodriguez |
First Address | Chicago, IL 60634 |
Second Address | Chicago, IL 60634 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2012 |
Last Update Date | 25/01/2012 |