Active NPI
Cybill Lisa Rodriguez, DMD
- Dentist
- Chicago, IL
National Provider Identifier
1083260301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019.032346
- Practice address
- 3501 N Halsted St
Chicago, IL 60657-1832 - Phone
- (773) 388-1600
- NPI assigned
- Aug 13, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.032346 | IL | Primary |
Addresses
Primary practice location
3501 N Halsted St
Chicago, IL 60657-1832
Mailing address
6348 S Austin Ave
Chicago, IL 60638-5341
Phone (773) 454-2858
Other practice location 1
7601 W Montrose Ave
Norridge, IL 60706-1000
Phone (773) 589-1062
Other practice location 2
6737 W Archer Ave
Chicago, IL 60638-2332
Phone (773) 586-5767
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.032346 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Howard Brown Health Center | Past | Accepting new patients |
Interoperability endpoints
- cybill.rodriguez.p15@direct.fhn-fqhc.nextgenshare.com
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Chicago, IL
- NPI 1912382227
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727395200000",
"number": "1083260301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6348 S AUSTIN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606385341",
"telephone_number": "773-454-2858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 N HALSTED ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606571832",
"telephone_number": "773-388-1600"
}
],
"practiceLocations": [
{
"address_1": "7601 W Montrose Ave",
"address_purpose": "LOCATION",
"city": "Norridge",
"state": "IL",
"postal_code": "607061000",
"country_code": "US",
"telephone_number": "773-589-1062",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "6737 W Archer Ave",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606382332",
"country_code": "US",
"telephone_number": "773-586-5767",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "CYBILL",
"middle_name": "LISA",
"name_prefix": "Ms.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-13",
"last_updated": "2024-09-27",
"certification_date": "2024-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019.032346",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.