Individual
LAUREN NICOLE MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1415 E STATE ST STE 101, ROCKFORD, IL 61104-2300
(779) 696-4891
Mailing address
1415 E STATE ST STE 101, ROCKFORD, IL 61104-2300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.012279
IL
363A00000X
Physician Assistant
PA61661485
WA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
02/05/2025
Last updated
07/09/2026
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