Hagen, Colleen A
Hagen, Colleen A is an individual health care provider with primary practice located at 1040 Woodview Rd , Burr Ridge IL 60527-4851. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Hagen, Colleen A can be contacted via phone (708) 579-9705.Contact Information
Primary practice address
1040 Woodview Rd
Burr Ridge IL 60527-4851
Phone: (708) 579-9705
Fax: (708) 579-0346
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X |
Profile Details
| NPI number | 1245333152 |
|---|---|
| LBN Legal business name | Hagen, Colleen A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 6th, 2006 |
| Last updated | Oct 25th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245333152 | NPPES |
| Illinois | Other | 31600057 | BC/BS |
| Illinois | MEDICAID | D14661 | BC/BS |
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