Individual
ANN HAGEDORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-1230
Mailing address
4550 MEMORIAL DR, STE 340, BELLEVILLE, IL 62226-5372
(618) 257-6200
(618) 257-6679
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036106952
IL
208M00000X
Hospitalist Physician
036106952
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036106952
—
IL
05
—
1245237825
—
IL
Enumeration date
06/28/2005
Last updated
05/10/2019
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