Individual
JADA H. HANSBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9300 WAUKEGAN ROAD, MORTON GROVE, IL 60053
(847) 675-3900
(847) 675-3930
Mailing address
2361 PAYSPHERE CIRCLE, CHICAGO, IL 60067
(800) 322-9183
(847) 535-8109
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003760
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085003760
STATE LICENCE
IL
Enumeration date
06/28/2010
Last updated
03/19/2025
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