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General NPI Number Information
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NPI Number | 1619318912
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Entity Type | Individual
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Provider Name | REBECCA ANNETTE OGLE
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Gender | Female
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 6918 WINDSOR AVE
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City | BERWYN
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State | IL
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Zip | 60402-3334
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Country | US
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Telephone | 708-745-5277
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Fax | 708-795-4834
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Provider Business Mailing Address
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Address Line | 9310 WALDEMAR RD
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-1134
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Country | US
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Telephone | 773-819-0494
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 34010719A
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License Number State | IN
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