Individual
DR. GARY JOHN ROGERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1921 LAKE AVE, SUITE A, WILMETTE, IL 60091-1480
(847) 256-4434
(847) 256-4437
Mailing address
1921 LAKE AVE, SUITE A, WILMETTE, IL 60091-1480
(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
09/12/2005
Last updated
07/22/2008
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