Provider Demographics
NPI:1609042902
Name:ROGERS, GINA M (MD)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:M
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2800 N SHERIDAN RD
Mailing Address - Street 2:#103
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6156
Mailing Address - Country:US
Mailing Address - Phone:773-525-8700
Mailing Address - Fax:773-525-8699
Practice Address - Street 1:2800 N SHERIDAN RD
Practice Address - Street 2:#103
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-6156
Practice Address - Country:US
Practice Address - Phone:773-525-8700
Practice Address - Fax:773-525-8699
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAR-8258207W00000X
IA39561207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology