Healthcare Provider Details

I. General information

NPI: 1932032695
Provider Name (Legal Business Name): AILEE HOGAN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 N CLARK ST
CHICAGO IL
60614-1768
US

IV. Provider business mailing address

637 9TH AVE
LA GRANGE IL
60525-3032
US

V. Phone/Fax

Practice location:
  • Phone: 773-755-7566
  • Fax:
Mailing address:
  • Phone: 708-548-3251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: