Provider Demographics
NPI:1730397118
Name:COGAN, DEBORAH LINDNER (MD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:LINDNER
Last Name:COGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DEBORAH
Other - Middle Name:SUE
Other - Last Name:LINDNER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4127 JAMES RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8943
Mailing Address - Country:US
Mailing Address - Phone:312-718-3051
Mailing Address - Fax:630-995-7965
Practice Address - Street 1:3156 DUSTIN RD STE 100
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-4300
Practice Address - Country:US
Practice Address - Phone:312-718-3051
Practice Address - Fax:630-995-7965
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
IL036118955202K00000X
IL12207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL125046156OtherSTATE OF IL LICENSE