Individual provider Active NPI

George Hoganson, MD

  • Clinical Genetics (M.D.) Physician
  • Chicago, IL
National Provider Identifier
1164497483
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
036-073221 Issued in IL
Practice address
840 S Wood St
M/C 856
Chicago, IL 60612-4325
Phone
(312) 355-0732
Fax
(312) 355-0739
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Genetics (M.D.) Physician 207SG0201X 036-073221 IL Primary
Clinical Biochemical Genetics Physician 207SG0202X 036-073221 IL
Clinical Molecular Genetics Physician 207SG0203X 036-073221 IL
Pediatrics Physician 208000000X 036-073221 IL

Addresses

Primary practice location

840 S Wood St
M/C 856
Chicago, IL 60612-4325

Mailing address

840 S Wood St
M/C 856
Chicago, IL 60612-4325
Phone (312) 355-0732

Other identifiers 2

IdentifierTypeStateIssuer
07215036OtherILBCBS
IL0194OtherILJOHN DEERE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025000446 IL Practitioner - Pediatric Medicine 8820059652 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-073221ILMDClinical Molecular Genetics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
RMH Pathologists, LTD Current Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Jan 1, 1987 Accepting new patients
Rockford Health Physicians CurrentSince Jan 1, 2005 Accepting new patients
Board of Trustees of the University of Illinois Pediatrics CurrentSince Jan 1, 1987 Accepting new patients
The Board of Trustees of the University of Illinois Past Accepting new patients
University of Illinois Past Accepting new patients

Locations

1855 W Taylor St
Chicago, IL 60612
Phone (312) 996-6582

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-4210

7732 Solution Ctr
Dept 3445 PEDS
Chicago, IL 60677

840 S Wood St
#856
Chicago, IL 60612
Phone (312) 413-1429

840 S Wood St
Chicago, IL 60612
Phone (312) 996-6043

7694 Solutions Ctr
Chicago, IL 60677

4440 W 95th St
Oak Lawn, IL 60453
Phone (708) 346-5520

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196812800000",
    "number": "1164497483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "M/C 856",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-355-0732",
            "fax_number": "312-355-0739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S WOOD ST",
            "address_2": "M/C 856",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124325",
            "telephone_number": "312-355-0732",
            "fax_number": "312-355-0739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGANSON",
        "first_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2007-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "IL",
            "license": "036-073221",
            "primary": true
        },
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "IL",
            "license": "036-073221",
            "primary": false
        },
        {
            "code": "207SG0203X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Molecular Genetics",
            "state": "IL",
            "license": "036-073221",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036-073221",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07215036",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "IL0194",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.