Healthcare Provider Details

I. General information

NPI: 1841376233
Provider Name (Legal Business Name): WILLIAM J HOGAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 S MAIN ST
LOMBARD IL
60148-3347
US

IV. Provider business mailing address

917 S MAIN ST
LOMBARD IL
60148-3347
US

V. Phone/Fax

Practice location:
  • Phone: 630-932-9663
  • Fax: 630-620-1901
Mailing address:
  • Phone: 630-932-9663
  • Fax: 630-620-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: