Individual provider Active NPI

Lauren Shana Hager, MD

  • Pediatrics Physician
  • Skokie, IL
National Provider Identifier
1578914024
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036.149812 Issued in IL
Practice address
4611 Golf Rd Ste 200
Skokie, IL 60076-1263
Phone
(857) 677-7250
NPI assigned
Jun 27, 2016
Last updated
Jun 26, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 125.068689 IL
Pediatrics Physician 208000000X 036.149812 IL Primary

Addresses

Primary practice location

4611 Golf Rd Ste 200
Skokie, IL 60076-1263

Mailing address

4611 Golf Rd Ste 200
Skokie, IL 60076-1263
Phone (847) 677-7250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803002551 IL Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3072807726

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.149812ILMDPediatrics Physician
125.068689ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kids' Health Partners, LLC Pediatrics Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1578914024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 GOLF RD STE 200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761263",
            "telephone_number": "847-677-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 GOLF RD STE 200",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761263",
            "telephone_number": "857-677-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGER",
        "first_name": "LAUREN",
        "middle_name": "SHANA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "125.068689",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.149812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.