Provider Demographics
NPI:1104007533
Name:VOGEL, JONATHAN EZRA (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:EZRA
Last Name:VOGEL
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2845 N SHERIDAN RD
Mailing Address - Street 2:STE 6400
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:312-332-2226
Mailing Address - Fax:
Practice Address - Street 1:2800 N SHERIDAN RD STE 600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6183
Practice Address - Country:US
Practice Address - Phone:312-263-2828
Practice Address - Fax:312-263-2759
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036120453208VP0000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine