Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 036157880 | IL |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 04-33092 | KS |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2007018003 | MO |
NPI | 1669417416 |
---|---|
Provider Name | Dr. James Winston Bogener |
First Address | Skokie, IL 60076-5006 |
Second Address | Skokie, IL 60076-5006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 23/08/2021 |