Provider Demographics
NPI:1851689665
Name:RODRIGUEZ CASANOVA, HECTOR (CP/LP)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:
Last Name:RODRIGUEZ CASANOVA
Suffix:
Gender:M
Credentials:CP/LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 WILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-4226
Mailing Address - Country:US
Mailing Address - Phone:630-718-9141
Mailing Address - Fax:
Practice Address - Street 1:1322 WILSHIRE DR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-4226
Practice Address - Country:US
Practice Address - Phone:630-718-9141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-13
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL211.000234224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist