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Individual

MRS. ROSANNE OGGOIAN

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
50 S MILWAUKEE AVE, SUITE 203, LAKE VILLA, IL 60046-9471
(847) 356-5747
(847) 356-5886
Mailing address
721 N MCKINLEY RD, FIRST FLOOR, LAKE FOREST, IL 60045-1849
(847) 735-9330
(847) 735-9301

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
2080A0000X
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04926673
BCBS
IL
Enumeration date
11/04/2005
Last updated
07/08/2007
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