| Jacqueline Rodriguez, DMD, P.C. | |
|
561 W Diversey Pkwy Ste 203 Chicago IL 60614-1682 | |
| (847) 738-7659 | |
| Not Available |
| Full Name | Jacqueline Rodriguez, DMD, P.C. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 561 W Diversey Pkwy Ste 203, Chicago, Illinois |
| Authorized Official Name and Position | Jacqueline Rodriguez (OWNER-DENTIST) |
| Authorized Official Contact | 8477387659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacqueline Rodriguez, DMD, P.C. 1513 W Thomas St Apt 3 Chicago IL 60642-3989 Ph: (847) 738-7659 | Jacqueline Rodriguez, DMD, P.C. 561 W Diversey Pkwy Ste 203 Chicago IL 60614-1682 Ph: (847) 738-7659 |
| NPI Number | 1326784398 |
|---|---|
| Provider Enumeration Date | 05/11/2022 |
| Last Update Date | 05/11/2022 |
| Certification Date | 05/11/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326784398 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | () | Primary |
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