Individual
JEREMY HOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
611 W PARK ST, IR, URBANA, IL 61801-2500
(217) 904-7000
(217) 904-7742
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036129966
IL
2085R0202X
Diagnostic Radiology Physician
103833
MN
2085R0202X
Diagnostic Radiology Physician
4301090815
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036129966
IL
Other
Enumeration date
07/26/2007
Last updated
08/23/2016
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