Provider Demographics
NPI:1669417416
Name:BOGENER, JAMES WINSTON (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WINSTON
Last Name:BOGENER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 GROSS POINT RD STE 2900
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-5006
Mailing Address - Country:US
Mailing Address - Phone:847-866-7846
Mailing Address - Fax:
Practice Address - Street 1:9650 GROSS POINT RD STE 2900
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-5006
Practice Address - Country:US
Practice Address - Phone:847-866-7846
Practice Address - Fax:224-251-2910
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007018003207XX0004X
KS04-33092207XX0004X
IL036157880207XX0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery