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General NPI Number Information
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NPI Number | 1528077948
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Entity Type | Individual
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Provider Name | BRIAN OGAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 1002 INTERSTATE DR STE 100
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City | CHAMPAIGN
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State | IL
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Zip | 61822-1465
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Country | US
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Telephone | 217-974-9366
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Fax | 800-801-3765
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Provider Business Mailing Address
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Address Line | 406 BRIERHILL RD
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City | DEERFIELD
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State | IL
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Zip | 60015-4402
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Country | US
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Telephone | 217-974-9366
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Fax | 800-801-3765
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036101808
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 336-067076
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 036-101808
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License Number State | IL
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