# DR. TATYANA KAGAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1508924267
- **Gender:** F
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | 036102378 | IL | — |
| 208000000X | Pediatrics Physician | 036-102378 | IL | — |
| 2080P0204X | Pediatric Emergency Medicine (Pediatrics) Physician | 036-102378 | IL | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 04/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 542161791 | TAX ID | IL |