Healthcare Provider Details

I. General information

NPI: 1679778294
Provider Name (Legal Business Name): MELISSA ELLEN HOGG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2650 RIDGE AVE. KELLOGG CANCER CENTER
EVANSTON IL
60201
US

IV. Provider business mailing address

2650 RIDGE AVE STE 1223
EVANSTON IL
60201-1700
US

V. Phone/Fax

Practice location:
  • Phone: 847-570-1700
  • Fax: 847-503-4371
Mailing address:
  • Phone: 847-570-1700
  • Fax: 847-503-4371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number036118547
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number036118547
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: