Dolph D Haege, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

036088001 Issued in IL

Practice address

211 S 3Rd St
Belleville, IL 62220-1915

Phone

(618) 234-2120

Fax

(618) 222-4630

NPI assigned

Oct 13, 2005

Last updated

Jul 1, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Pathology Services LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Belleville, IL
  • NPI 1306834346
  Authorized official Same address or phone
• Southern Illinois Histology, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Granite City, IL
  • NPI 1215208798
  Authorized official Same address or phone
• Essential Testing, LLC

  • Clinical Medical Laboratory
  • Collinsville, IL
  • NPI 1316225956
  NPD
• Carestl Health

  • Federally Qualified Health Center (FQHC)
  • Overland, MO
  • NPI 1275363137
  NPD
• Carestl Health

  dba Homer G. Phillips Health Center

  • Federally Qualified Health Center (FQHC)
  • Saint Louis, MO
  • NPI 1376685529
  NPD
• Carestl Health

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1972596088
  NPD
• Carestl Health

  • Federally Qualified Health Center (FQHC)
  • Jennings, MO
  • NPI 1912440876
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214870400000",
    "number": "1639167570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 144333",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328144333",
            "telephone_number": "407-422-9831",
            "fax_number": "407-648-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 S 3RD ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201915",
            "telephone_number": "618-234-2120",
            "fax_number": "618-222-4630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAEGE",
        "first_name": "DOLPH",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2008-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036088001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00250827",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208789008",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0360880012",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frederick Gustave, DDS
• Corrina M Guthrie, PTA, ATC
• Virgilio T Guzman, MD
• Gwinn Chiropractic Center
• Megan Renee Gwinn, D.C.
• Sharon Faye Haege
• Michele Anette Hagarty, APN
• Dean David Hageman, M.D.
• Matthew Dean Hageman, MD
• Ganan Hahn, PA

• Anatomic Pathology & Clinical Pathology Physician in Belleville, IL
• Providers in Belleville, IL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.