Individual provider Active NPI

Jacqueline Marguerite Rodriguez, DMD

  • General Practice Dentistry
  • Chicago, IL
National Provider Identifier
1750801585
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019031100 Issued in IL
Practice address
8 S Michigan Ave Ste 210
Chicago, IL 60603-3475
Phone
(312) 283-3757
NPI assigned
Jun 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019031100 IL Primary

Addresses

Primary practice location

8 S Michigan Ave Ste 210
Chicago, IL 60603-3475

Mailing address

1513 W Thomas St Apt 3
Chicago, IL 60642-3989
Phone (847) 738-7659

Other practice location 1

13033 S La Grange Rd
Palos Park, IL 60464-1718
Phone (708) 361-4300

Other practice location 2

568 S Spring Rd
Elmhurst, IL 60126-3868
Phone (630) 833-5007

Other practice location 3

8 S Michigan Ave Ste 210
Chicago, IL 60603-3475
Phone (312) 283-3757

Other practice location 4

10601 S Western Ave
Chicago, IL 60643-3100
Phone (773) 238-3200

Other practice location 5

10601 S Western Ave
Chicago, IL 60643-3100
Phone (773) 238-3200

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

LicenseStateTypeSpecialty
019031100ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Jacqueline Rodriguez, DMD, P.C. CurrentSince May 16, 2022 Accepting new patients
All Perfect Smiles General Practice Past Accepting new patients
All Perfect Smiles of Beverly PC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1750801585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1513 W THOMAS ST APT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606423989",
            "telephone_number": "847-738-7659",
            "fax_number": "847-738-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 S MICHIGAN AVE STE 210",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033475",
            "telephone_number": "312-283-3757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13033 S La Grange Rd",
            "address_purpose": "LOCATION",
            "city": "Palos Park",
            "state": "IL",
            "postal_code": "604641718",
            "country_code": "US",
            "telephone_number": "708-361-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "568 S Spring Rd",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "IL",
            "postal_code": "601263868",
            "country_code": "US",
            "telephone_number": "630-833-5007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8 S Michigan Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606033475",
            "country_code": "US",
            "telephone_number": "312-283-3757",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10601 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606433100",
            "country_code": "US",
            "telephone_number": "773-238-3200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10601 S Western Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606433100",
            "country_code": "US",
            "telephone_number": "773-238-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "JACQUELINE",
        "middle_name": "MARGUERITE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019031100",
            "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 Mar 25, 2022; 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.