Provider Demographics
NPI:1760878995
Name:RODRIGUEZ ARAIZA, GLADYS MAGALY (MD)
Entity Type:Individual
Prefix:
First Name:GLADYS
Middle Name:MAGALY
Last Name:RODRIGUEZ ARAIZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GLADYS
Other - Middle Name:MAGALY
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:675 N SAINT CLAIR ST STE 21-100
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-5970
Mailing Address - Country:US
Mailing Address - Phone:312-695-6180
Mailing Address - Fax:312-695-1106
Practice Address - Street 1:675 N SAINT CLAIR ST STE 21-100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-5970
Practice Address - Country:US
Practice Address - Phone:312-695-6180
Practice Address - Fax:312-695-1106
Is Sole Proprietor?:No
Enumeration Date:2015-04-14
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147390207R00000X
IL036163019207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine