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General NPI Number Information
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NPI Number | 1427103852
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Entity Type | Individual
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Provider Name | CLIFFORD A RODE PT
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Gender | Male
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Dates
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Enumeration Date | 01/24/2007
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 1431 N WESTERN AVE 140
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City | CHICAGO
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State | IL
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Zip | 60622-1797
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Country | US
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Telephone | 773-235-1900
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Fax | 773-235-1902
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Provider Business Mailing Address
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Address Line | 8526 N OLEANDER AVE
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City | NILES
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State | IL
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Zip | 60714-2056
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 070002602
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License Number State | IL
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