Provider Demographics
NPI:1578914024
Name:HAGER, LAUREN SHANA (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:SHANA
Last Name:HAGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 GOLF RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1263
Mailing Address - Country:US
Mailing Address - Phone:847-677-7250
Mailing Address - Fax:
Practice Address - Street 1:4611 GOLF RD STE 200
Practice Address - Street 2:
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1263
Practice Address - Country:US
Practice Address - Phone:857-677-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.068689208000000X
IL036.149812208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics