Harvey Michael Bogin
Individual provider Active NPI General Practice Dentistry · Winfield, IL
NPI 1407006455 · NPPES record last updated Sep 26, 2008
Key facts
- NPI
- 1407006455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 19015394 (IL)
- Practice address
- Os 160 Church St
Winfield, IL 60190 - Phone
- (630) 668-6352
- NPI assigned
- Sep 26, 2008
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19015394 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 19015394 | IL | Yes |
Addresses
Primary practice location
Os 160 Church St
Winfield, IL 60190
Mailing address
Os 160 Church St
Winfield, IL 60190
Phone (630) 668-6352
Other providers in Winfield, IL
- Maurice W Birt
- Lauren Blade
- Ebonee Monique Blake
- Joshua A Blomgren
- Sarah A Boecker
- Sarah Elizabeth Bogin
- Nathan Ruhl Bolden
- Fred Craig Bollhoffer
- Emina Bolt
- Kirsten Book
All providers in Winfield, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.