Provider Demographics
NPI:1558356964
Name:HOGAN, LINDA ANN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:ANN
Last Name:HOGAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6157 N SHERIDAN RD
Mailing Address - Street 2:APT 3K
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-2770
Mailing Address - Country:US
Mailing Address - Phone:773-764-3170
Mailing Address - Fax:
Practice Address - Street 1:1830 SHERMAN AVE
Practice Address - Street 2:STE 303
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-3798
Practice Address - Country:US
Practice Address - Phone:847-491-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-13
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149003875104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001626774OtherBCBS OF IL
IL0001626774OtherBCBS OF IL