Provider Demographics
NPI:1609024819
Name:DRIMER, LAUREN NICOLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NICOLE
Last Name:DRIMER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7425 BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60133-2241
Mailing Address - Country:US
Mailing Address - Phone:630-823-0392
Mailing Address - Fax:630-855-6349
Practice Address - Street 1:7425 BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:HANOVER PARK
Practice Address - State:IL
Practice Address - Zip Code:60133-2241
Practice Address - Country:US
Practice Address - Phone:630-823-0392
Practice Address - Fax:630-855-6349
Is Sole Proprietor?:No
Enumeration Date:2008-08-29
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601005394363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical