Provider Demographics
NPI:1992790182
Name:JAGER, RAMA D (MD)
Entity type:Individual
Prefix:
First Name:RAMA
Middle Name:D
Last Name:JAGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
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Mailing Address - Street 1:6320 159TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2776
Mailing Address - Country:US
Mailing Address - Phone:708-687-2222
Mailing Address - Fax:708-687-3829
Practice Address - Street 1:6320 159TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-2776
Practice Address - Country:US
Practice Address - Phone:708-687-2222
Practice Address - Fax:708-687-3829
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036109481207WX0107X
IL036-109481207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036109481Medicaid
IL036109481Medicaid