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General NPI Number Information
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NPI Number | 1710013412
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Entity Type | Individual
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Provider Name | MARLENE R VOGT OTR
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10187 BENNINGTON DR
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City | HUNTLEY
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State | IL
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Zip | 60142-2336
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Country | US
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Telephone | 847-791-4089
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Fax | 847-669-9429
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Provider Business Mailing Address
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Address Line | 10187 BENNINGTON DR
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City | HUNTLEY
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State | IL
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Zip | 60142
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Country | US
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Telephone | 847-791-4089
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Fax | 847-669-9429
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | IL
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