Provider Demographics
NPI:1982940631
Name:POGORILER, JENNIFER EDEN (MD PHD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:EDEN
Last Name:POGORILER
Suffix:
Gender:F
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 S. MARYLAND AVE, MC 6101, ROOM P615A,
Mailing Address - Street 2:UNIVERSITY OF CHICAGO DEPARTMENT OF PATHOLOGY
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637
Mailing Address - Country:US
Mailing Address - Phone:773-834-8382
Mailing Address - Fax:
Practice Address - Street 1:5841 S. MARYLAND AVE, MC 6101, ROOM P615A
Practice Address - Street 2:UNIVERSITY OF CHICAGO DEPARTMENT OF PATHOLOGY
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637
Practice Address - Country:US
Practice Address - Phone:773-834-8382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.129498207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology