Provider Demographics
NPI:1326545724
Name:AVILA RODRIGUEZ, ANA MARIA (MD)
Entity type:Individual
Prefix:
First Name:ANA MARIA
Middle Name:
Last Name:AVILA RODRIGUEZ
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 S WOOD ST STE 820-E
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:312-996-9424
Mailing Address - Fax:312-413-4131
Practice Address - Street 1:840 S WOOD ST STE 820-E
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4325
Practice Address - Country:US
Practice Address - Phone:312-996-9424
Practice Address - Fax:312-413-4131
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2025-04-03
Deactivation Date:2018-11-16
Deactivation Code:
Reactivation Date:2018-12-26
Provider Licenses
StateLicense IDTaxonomies
IL036167100207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine