Individual provider Active NPI

Rosanne Oggoian, D.O.

  • Pediatric Adolescent Medicine Physician
  • Lake Villa, IL
National Provider Identifier
1043201387
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
2080A0000X Issued in IL
Practice address
50 S Milwaukee Ave
Suite 203
Lake Villa, IL 60046-9471
Phone
(847) 356-5747
Fax
(847) 356-5886
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 2080A0000X IL Primary

Addresses

Primary practice location

50 S Milwaukee Ave
Suite 203
Lake Villa, IL 60046-9471

Mailing address

721 N McKinley Rd
First Floor
Lake Forest, IL 60045-1849
Phone (847) 735-9330

Other identifiers 1

IdentifierTypeStateIssuer
04926673OtherILBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2080A0000XILMDPediatric Adolescent Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1043201387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 N MCKINLEY RD",
            "address_2": "FIRST FLOOR",
            "city": "LAKE FOREST",
            "state": "IL",
            "postal_code": "600451849",
            "telephone_number": "847-735-9330",
            "fax_number": "847-735-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S MILWAUKEE AVE",
            "address_2": "SUITE 203",
            "city": "LAKE VILLA",
            "state": "IL",
            "postal_code": "600469471",
            "telephone_number": "847-356-5747",
            "fax_number": "847-356-5886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGGOIAN",
        "first_name": "ROSANNE",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "IL",
            "license": "2080A0000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04926673",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Villa, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.