Provider Demographics
NPI:1669282620
Name:HOGE, GRETCHEN (PHD, MSW)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:HOGE
Suffix:
Gender:F
Credentials:PHD, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17735 TULIP LN
Mailing Address - Street 2:
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-6584
Mailing Address - Country:US
Mailing Address - Phone:708-638-2167
Mailing Address - Fax:
Practice Address - Street 1:101 BURR RIDGE PKWY STE 200
Practice Address - Street 2:
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60527-0846
Practice Address - Country:US
Practice Address - Phone:630-563-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490272651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical