Individual
MIRA ELIZABETH HAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4417 W DIVERSEY AVE, CHICAGO, IL 60639-1923
(773) 377-7736
(815) 642-5723
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(312) 733-9730
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007008
IL
Other
Enumeration date
12/02/2018
Last updated
06/05/2025
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