Provider Demographics
NPI:1770252637
Name:RODRIGUEZ, LENORA JEAN
Entity Type:Individual
Prefix:
First Name:LENORA
Middle Name:JEAN
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W SHURE DR STE 240
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1478
Mailing Address - Country:US
Mailing Address - Phone:224-828-2068
Mailing Address - Fax:
Practice Address - Street 1:1500 W SHURE DR STE 240
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1478
Practice Address - Country:US
Practice Address - Phone:224-828-2068
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker