Rodriquez, Jack
Rodriquez, Jack is an sole proprietor health care provider with primary practice located at 6072 Brynwood Dr , Rockford IL 61114-5829. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Rodriquez, Jack can be contacted via phone (815) 636-0825.Contact Information
Primary practice address
6072 Brynwood Dr
Rockford IL 61114-5829
Phone: (815) 636-0825
Fax: (815) 636-2271
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | Illinois |
Profile Details
| NPI number | 1033199054 |
|---|---|
| LBN Legal business name | Rodriquez, Jack |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 17th, 2006 |
| Last updated | Jul 16th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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