Individual
DR. COLLEEN A HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1040 WOODVIEW RD, BURR RIDGE, IL 60527-4851
(708) 579-9705
(708) 579-0346
Mailing address
1040 WOODVIEW RD, BURR RIDGE, IL 60527-4851
(708) 579-9705
(708) 579-0346
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31600057
BC/BS
IL
05
—
D14661
—
IL
Enumeration date
09/06/2006
Last updated
10/25/2021
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