Healthcare Provider Details

I. General information

NPI: 1376427575
Provider Name (Legal Business Name): JULIANI RODRIGUEZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2025
Last Update Date: 08/01/2025
Certification Date: 08/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 S PAULINA ST STE 1080
CHICAGO IL
60612-3806
US

IV. Provider business mailing address

1111 S WABASH AVE APT 605
CHICAGO IL
60605-2359
US

V. Phone/Fax

Practice location:
  • Phone: 312-942-7117
  • Fax:
Mailing address:
  • Phone: 608-733-0437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number041.551253
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: