Provider Demographics
NPI:1043008568
Name:RODRIGUEZ, INGRID SHIOMARA (LSW)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:SHIOMARA
Last Name:RODRIGUEZ
Suffix:
Gender:
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14722 S NAPERVILLE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-3303
Mailing Address - Country:US
Mailing Address - Phone:779-234-9064
Mailing Address - Fax:
Practice Address - Street 1:14722 S NAPERVILLE RD STE 110
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-3303
Practice Address - Country:US
Practice Address - Phone:779-234-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-25
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker