Search › Illinois › 122300000X
Eric Hagen, DMD
NPI 1407415995 · on the registry since 2019 · sole proprietor
Practice
- Address
- 5505 N Clark St
Chicago, IL 60640 - Phone
- (773) 365-9928
- Organisation at this address
- Kapil Kella Dds Pc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-09-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois