Bagdon, Jeffrey D

Bagdon, Jeffrey D is an individual health care provider with primary practice located at 2000 Lake Ave , Woodstock IL 60098-7401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bagdon, Jeffrey D can be contacted via phone (815) 337-7100.

Contact Information

Primary practice address
2000 Lake Ave Woodstock IL 60098-7401
Phone: (815) 337-7100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X Illinois

Profile Details

NPI number 1518987528
LBN Legal business name Bagdon, Jeffrey D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518987528 NPPES
Illinois MEDICAID 036098629 2

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