Hogan, Casey L

Hogan, Casey L is an individual health care provider with primary practice located at 4619 W 103Rd St , Oak Lawn IL 60453-4718. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Hogan, Casey L can be contacted via phone (708) 229-2200.

Contact Information

Primary practice address
4619 W 103Rd St Oak Lawn IL 60453-4718
Fax: (708) 229-2233
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 046009033 Illinois

Profile Details

NPI number 1346233889
LBN Legal business name Hogan, Casey L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2005
Last updated Apr 21st, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346233889 NPPES
Illinois MEDICAID 046009033

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