Organization
BROMENN HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY A HAGENS DMD (CHIEF OPERATING OFFICER AND VPMA)
(309) 268-2003
Entity
Organization
Contact information
Practice address
1300 FRANKLIN AVENUE, SUITE 250, NORMAL, IL 61761-3699
(309) 268-3642
(309) 268-3649
Mailing address
1300 FRANKLIN AVENUE, SUITE 250, NORMAL, IL 61761-3699
(309) 268-3642
(309) 268-3649
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
06/17/2006
Last updated
03/31/2008
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