Organization
GARY J ROGERS DPM PC
Active
Other names
ROGERS PODIATRY DPM
Organization subpart
No
Provider details
NPI number
Authorized official
GARY ROGERS DPM (OWNER)
(847) 256-4434
Entity
Organization
Contact information
Practice address
1919 LAKE AVE STE A, WILMETTE, IL 60091-1422
(847) 256-4434
(847) 256-4437
Mailing address
1919 LAKE AVE STE A, WILMETTE, IL 60091-1422
(847) 256-4434
(847) 256-4437
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
016004888
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021622507
BCBS
IL
Enumeration date
04/13/2007
Last updated
09/18/2014
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