Nicholas Rodriguez
Individual provider Active NPI Occupational Therapist · Bolingbrook, IL
NPI 1508300567 · NPPES record last updated Dec 10, 2016
Key facts
- NPI
- 1508300567
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 056011717 (IL)
- Practice address
- 334 Stafford Way
Bolingbrook, IL 60440-2128 - Phone
- (630) 484-1113
- NPI assigned
- Dec 10, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 056011717 | IL | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 056011717 | IL | Yes |
Addresses
Primary practice location
334 Stafford Way
Bolingbrook, IL 60440-2128
Mailing address
334 Stafford Way
Bolingbrook, IL 60440-2128
Other providers in Bolingbrook, IL
- Meghan Rodes
- Gary A. Rodgers
- Alexis Sabrina Rodriguez
- Catherine Rodriguez
- James Ronald Rodriguez
- Joyce Roesler
- Collin Joseph Rogers
- Huma Q. Rohail
- Elisabeth Roman
- Adriana Romero
All providers in Bolingbrook, IL · Occupational Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.