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NPI Code Detail

MEDICARE: DR. TODD S HAGLE M.D.

MEDICARE:  DR. TODD S HAGLE  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0014XInterventional Pain Medicine Physician036111605IL
2207LP2900XPain Medicine (Anesthesiology) Physician036111605IL

General Provider Information

NPI Number : 1609929462
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD S HAGLE M.D.
Provider Business Mailing Address
First Line : 329 REMINGTON BLVD STE 205
Second Line :
City : BOLINGBROOK
State : IL
Zip : 60440-5817
Country : US
Telephone Number : 630-226-1130
Fax Number : 630-226-1134
Provider Business Practice Location Address
First Line : 2210 DEAN ST STE K
Second Line :
City : SAINT CHARLES
State : IL
Zip : 60175-1059
Country : US
Telephone Number : 630-223-1130
Fax Number : 630-226-1134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2007
Last Update Date : 02/09/2022

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Directions to “ DR. TODD S HAGLE M.D.” Practice Location

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