Healthcare Provider Details

I. General information

NPI: 1912836719
Provider Name (Legal Business Name): PATRICIA MAYER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 MADISON ST
CROWN POINT IN
46307-7745
US

IV. Provider business mailing address

9301 MADISON ST
CROWN POINT IN
46307-7745
US

V. Phone/Fax

Practice location:
  • Phone: 312-569-5045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number28219498A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: