Provider Demographics
NPI:1124724240
Name:RODRIGUEZ, CHRISTINE JEAN (APRN)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:JEAN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1755 THORNEAPPLE LN
Mailing Address - Street 2:
Mailing Address - City:ALGONQUIN
Mailing Address - State:IL
Mailing Address - Zip Code:60102-3933
Mailing Address - Country:US
Mailing Address - Phone:847-239-3253
Mailing Address - Fax:
Practice Address - Street 1:2200 W HIGGINS RD STE 140
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-2422
Practice Address - Country:US
Practice Address - Phone:847-781-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILF10220886363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner