Healthcare Provider Details

I. General information

NPI: 1932668779
Provider Name (Legal Business Name): LEXIE SHOGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1739 N ELSTON AVE
CHICAGO IL
60642-1544
US

IV. Provider business mailing address

3807 N RICHMOND ST
CHICAGO IL
60618-3526
US

V. Phone/Fax

Practice location:
  • Phone: 773-687-9241
  • Fax:
Mailing address:
  • Phone: 815-762-4046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number146.013808
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: