Healthcare Provider Details

I. General information

NPI: 1730397118
Provider Name (Legal Business Name): DEBORAH LINDNER COGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEBORAH SUE LINDNER MD

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 10/07/2021
Certification Date: 10/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3156 DUSTIN RD STE 100
OREGON OH
43616-4300
US

IV. Provider business mailing address

4127 JAMES RIVER RD
NEW ALBANY OH
43054-8943
US

V. Phone/Fax

Practice location:
  • Phone: 312-718-3051
  • Fax: 630-995-7965
Mailing address:
  • Phone: 312-718-3051
  • Fax: 630-995-7965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number036118955
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number12
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: