Jack Rodriquez, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Practice address

6072 Brynwood Dr
Rockford, IL 61114-5829

Phone

(815) 636-0825

Fax

(815) 636-2271

NPI assigned

Jan 17, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184544000000",
    "number": "1033199054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15105",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611325105",
            "telephone_number": "815-654-7772",
            "fax_number": "815-654-7009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6072 BRYNWOOD DR",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611145829",
            "telephone_number": "815-636-0825",
            "fax_number": "815-636-2271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIQUEZ",
        "first_name": "JACK",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-17",
        "last_updated": "2007-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aleida Rodriguez
• Danielle Suzanne Rodriguez, APRN
• Isabella Rodriguez
• Itzayana Rodriguez
• Pedro Rodriguez, MD
• Douglas Paul Roegner, M.D.
• Jennifer S Roessler, PT, MPT
• Ashley R Rogers, ATC
• Catherine A Rogers, APRN
• Craig B. Rogers, MD

• Psychiatry Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.