Hansberry, Jada

Hansberry, Jada is an individual health care provider with primary practice located at 1000 N Westmoreland Rd # Level1 , Lake Forest IL 60045-1658. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Hansberry, Jada can be contacted via phone (847) 535-7647.

Contact Information

Primary practice address
1000 N Westmoreland Rd # Level1 Lake Forest IL 60045-1658
Phone: (847) 535-7647
Fax: (847) 535-8109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085003760 Illinois

Profile Details

NPI number 1326359100
LBN Legal business name Hansberry, Jada
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2010
Last updated Feb 13th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326359100 NPPES
Illinois Other 085003760 STATE LICENCE

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