Individual
LEA MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
225 E CHICAGO AVE, CHICAGO, IL 60611-2991
(123) 227-4831
Mailing address
1530 S STATE ST APT 1128, CHICAGO, IL 60605-2988
(603) 843-7082
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
209.017977
IL
Other
Enumeration date
04/11/2018
Last updated
10/23/2024
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