Individual
TRACEY OGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-8161
Mailing address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209-014693
IL
363LP0222X
Critical Care Pediatric Nurse Practitioner
041382062
IL
Other
Enumeration date
07/06/2016
Last updated
12/29/2025
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