Individual
CHRISTOPHER L MOGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
751 N RUTLEDGE ST, ROOM 1100, SPRINGFIELD, IL 62702-4909
(217) 545-0173
(217) 545-5459
Mailing address
PO BOX 19639, SPRINGFIELD, IL 62794-9639
(217) 545-7578
(217) 545-1884
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209-006680
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00460018
RAILROAD MEDICARE
IL
Enumeration date
07/31/2007
Last updated
12/08/2020
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