Provider Demographics
NPI:1558815829
Name:HOGGE, ROBERT (LCSW 149022863)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:HOGGE
Suffix:
Gender:M
Credentials:LCSW 149022863
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ROBERT HOGGE, LCSW
Mailing Address - Street 2:1740 W. TAYLOR ST.
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612
Mailing Address - Country:US
Mailing Address - Phone:312-996-2242
Mailing Address - Fax:312-413-9148
Practice Address - Street 1:ROBERT HOGGE, LCSW
Practice Address - Street 2:1740 W. TAYLOR ST.
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-996-2242
Practice Address - Fax:312-413-9148
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-04
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490228631041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL362235165Medicaid