Provider Demographics
NPI:1952619926
Name:RODRIGUEZ, NANCY A (RN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:A
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN, CDCES
Other - Prefix:MRS
Other - First Name:NANCY
Other - Middle Name:A
Other - Last Name:APONTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CDCES
Mailing Address - Street 1:645 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60644-5059
Mailing Address - Country:US
Mailing Address - Phone:773-854-5218
Mailing Address - Fax:
Practice Address - Street 1:645 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60644-5059
Practice Address - Country:US
Practice Address - Phone:773-854-5218
Practice Address - Fax:773-854-5587
Is Sole Proprietor?:No
Enumeration Date:2010-09-23
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003425163WD0400X
IL041.211788163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator