Individual
MRS. LISA A. BOGET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4948 BENCHMARK CENTRE DR, SWANSEA, IL 62226-2027
(618) 628-2588
(618) 628-1363
Mailing address
4948 BENCHMARK CENTRE DR, SWANSEA, IL 62226-2027
(618) 628-2588
(618) 628-1363
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
085000996
IL
363AM0700X
Medical Physician Assistant
PA752
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000324636
ANTHEM
KY
05
—
1619083102
—
IL
01
—
P00080693
RAILROAD MEDICARE
KY
Enumeration date
08/21/2006
Last updated
03/04/2025
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