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Individual

LISA HAGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1 PARK PL, SWANSEA, IL 62226-2965
(618) 233-3040
(618) 233-3739
Mailing address
1 PARK PL, SWANSEA, IL 62226-2965
(618) 233-3040
(618) 233-3739

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046-009861
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046009861
IL
01
0814870008
MEDICARE NSC NUMBER
IL
01
0814870023
MEDICARE NSC NUMBER
IL
01
0814870029
MEDICARE NSC NUMBER
IL
01
0814870031
MEDICARE NSC NUMBER
IL
01
120175
HEALTH ALLIANCE
01
IL2376
EYEMED
01
P00410559, CA2196
MEDICARE RAILROAD
IL
01
P01665024
RAILROAD MEDICARE
IL
Enumeration date
07/18/2006
Last updated
02/20/2023
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