Individual
DR. MITCHELE HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
822 S MILLER ST, CHICAGO, IL 60607-4207
(312) 733-9010
Mailing address
826 S MILLER ST, CHICAGO, IL 60607-4207
(312) 733-9010
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
336.027529 036.06299
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062994
—
IL
Enumeration date
10/04/2006
Last updated
06/01/2017
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