Provider Demographics
NPI:1689458317
Name:HOGAN, AMY CHRISTINE
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CHRISTINE
Last Name:HOGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-2715
Mailing Address - Country:US
Mailing Address - Phone:630-217-1742
Mailing Address - Fax:
Practice Address - Street 1:117 FLINN ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2471
Practice Address - Country:US
Practice Address - Phone:224-803-2295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker