Provider Demographics
NPI:1164157079
Name:RHODES, DANA BARBARA (RN)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:BARBARA
Last Name:RHODES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 W ONTARIO ST STE 400
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3619
Mailing Address - Country:US
Mailing Address - Phone:312-912-7008
Mailing Address - Fax:312-533-2842
Practice Address - Street 1:226 W ONTARIO ST STE 400
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3619
Practice Address - Country:US
Practice Address - Phone:312-912-7008
Practice Address - Fax:312-533-2842
Is Sole Proprietor?:No
Enumeration Date:2022-07-24
Last Update Date:2022-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IL041466458163WP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health