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1659734838

NPI Code Detail

MEDICARE: LUCY JAGER MD

MEDICARE: LUCY JAGER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZC0500X	Cytopathology Physician	036.152964	IL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	036152964	IL

General Provider Information

NPI Number	:	1659734838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCY JAGER MD

Provider Business Mailing Address
First Line	:	251 E HURON ST STE 7-132H
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2908
Country	:	US
Telephone Number	:	312-926-6692
Fax Number	:	312-503-8249

Provider Business Practice Location Address
First Line	:	251 E HURON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2908
Country	:	US
Telephone Number	:	312-503-8144
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2016
Last Update Date	:	11/22/2023

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Directions to “ LUCY JAGER MD” Practice Location

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