Individual
DR. JACKLYN M HAGEDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1653 W CONGRESS PKWY, CHICAGO, IL 60612-3833
(312) 942-5000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-5901
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125053105
IL
207RP1001X
Pulmonary Disease Physician
Primary
036129053
IL
Other
Enumeration date
06/13/2008
Last updated
01/20/2016
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