Individual
BRANDON HAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
912 S WOOD ST, CHICAGO, IL 60612-4300
(312) 355-3016
Mailing address
912 S WOOD ST, CHICAGO, IL 60612-4300
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036160942
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036160942
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/29/2017
Last updated
08/31/2022
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