Individual
GEORGE HOGANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
840 S WOOD ST, M/C 856, CHICAGO, IL 60612-4325
(312) 355-0732
(312) 355-0739
Mailing address
840 S WOOD ST, M/C 856, CHICAGO, IL 60612-4325
(312) 355-0732
(312) 355-0739
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
036-073221
IL
207SG0202X
Clinical Biochemical Genetics Physician
036-073221
IL
207SG0203X
Clinical Molecular Genetics Physician
036-073221
IL
208000000X
Pediatrics Physician
036-073221
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07215036
BCBS
IL
01
—
IL0194
JOHN DEERE
IL
Enumeration date
02/21/2006
Last updated
12/05/2007
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