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General NPI Number Information
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NPI Number | 1952220402
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Entity Type | Individual
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Provider Name | BRIDGET HAGEDORN
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Gender | Female
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 2350 RAVINE WAY STE 600
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City | GLENVIEW
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State | IL
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Zip | 60025-7657
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Country | US
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Telephone | 847-324-3020
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Fax | 847-998-9693
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Provider Business Mailing Address
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Address Line | 250 S NORTHWEST HWY STE 200
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City | PARK RIDGE
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State | IL
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Zip | 60068-4252
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Country | US
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Telephone | 847-324-3976
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Fax | 847-929-1154
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | IL
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