Provider Demographics
NPI:1386938678
Name:RODRIGUEZ, NATALIE MARIE
Entity type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:MARIE
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARIE
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1105 S FORUMS CT
Mailing Address - Street 2:1 C
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-5633
Mailing Address - Country:US
Mailing Address - Phone:630-744-9050
Mailing Address - Fax:
Practice Address - Street 1:1105 S FORUMS CT
Practice Address - Street 2:1 C
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5633
Practice Address - Country:US
Practice Address - Phone:630-744-9050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor