Individual
DR. ERIC MICHAEL HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5505 N CLARK ST, CHICAGO, IL 60640-1213
(773) 365-9928
Mailing address
2025 OXNARD DR, DOWNERS GROVE, IL 60516-2514
(708) 845-6556
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032150
IL
1223G0001X
General Practice Dentistry
019.032150
IL
Other
Enumeration date
06/10/2019
Last updated
09/18/2024
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