Individual
DR. MARY ELIZABETH HOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
917 S MAIN ST, LOMBARD, IL 60148-3347
(630) 932-9663
(630) 620-1901
Mailing address
917 S MAIN ST, LOMBARD, IL 60148-3347
(630) 932-9663
(630) 620-1901
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038003995
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002205085
BCBS
IL
05
—
PA038003995
—
IL
Enumeration date
09/14/2006
Last updated
08/03/2012
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