MEDICARE: DENNIS ROGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	3156	IL

General Provider Information

NPI Number	:	1952790701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS ROGAN

Provider Business Mailing Address
First Line	:	840 S WAUKEGAN RD
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045-2608
Country	:	US
Telephone Number	:	244-544-5144
Fax Number	:	244-544-5780

Provider Business Practice Location Address
First Line	:	840 S WAUKEGAN RD
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045-2608
Country	:	US
Telephone Number	:	244-544-5144
Fax Number	:	244-544-5780

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/16/2015
Last Update Date	:	01/16/2015

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Directions to “ DENNIS ROGAN ” Practice Location

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