IndividualActive
Crystal Bogan
NPI 1174333041 · Community Health Worker · Chicago, IL
Provider details
- NPI number
- 1174333041
- Entity type
- Individual
- Primary specialty
- Community Health WorkerOther Service Providers
- Sex
- Female
- Sole proprietor
- Yes
- License
- 126200888 (IL)
Specialties & taxonomies
Other Service Providers
Practice location
438 E 40th St Apt B
Chicago, IL 60653-4983
Phone: (773) 887-0729
Approximate (ZIP-level) locationGet directions
Mailing address
438 E 40th St Apt B
Chicago, IL 60653-4983
Registry dates
- Enumerated
- 2025-01-13
- Last updated
- 2025-01-13
- Certified
- 2025-01-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.