Individual
MONICA KOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1611 W HARRISON ST, #400, CHICAGO, IL 60612-4861
(312) 243-4244
(312) 942-1517
Mailing address
1 WESTBROOK CORPORATE CTR, #240, WESTCHESTER, IL 60154-5701
Taxonomy
Speciality
Code
Description
License number
State
207XP3100X
Pediatric Orthopaedic Surgery Physician
Primary
036116750
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116750 1
—
IL
01
—
1633878
BCBS GROUP ID#
IL
01
—
207067
MEDICARE LOCALITY #16
IL
01
—
207073
MEDICARE LOCALITY #15
IL
01
—
7943309
AETNA ID#
IL
Enumeration date
01/17/2006
Last updated
04/12/2021
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