Provider Demographics
NPI:1083924856
Name:RODEBACK, CATHERINE (L AC)
Entity Type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:
Last Name:RODEBACK
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 KEYES AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60140-9447
Mailing Address - Country:US
Mailing Address - Phone:847-567-2730
Mailing Address - Fax:
Practice Address - Street 1:187 KEYES AVE
Practice Address - Street 2:
Practice Address - City:HAMPSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60140-9447
Practice Address - Country:US
Practice Address - Phone:847-567-2730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist