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Individual
LAUREN E MAZUR
Active
Individual
LAUREN E MAZUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085002391
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209118
MEDICARE PTAN LOCALITY 15
IL
01
—
209119
MEDICARE PTAN LOCALITY 16
IL
Enumeration date
05/30/2006
Last updated
10/20/2025
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