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NPI Code Detail

MEDICARE: AMANDA RODRIGUEZ RN

MEDICARE: AMANDA RODRIGUEZ RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse041.499229IL

General Provider Information

NPI Number : 1750236972
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA RODRIGUEZ RN
Provider Business Mailing Address
First Line : 155 E BRUSH HILL RD
Second Line :
City : ELMHURST
State : IL
Zip : 60126-5658
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 155 E BRUSH HILL RD
Second Line :
City : ELMHURST
State : IL
Zip : 60126-5658
Country : US
Telephone Number : 331-221-5900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2026
Last Update Date : 03/03/2026

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