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NPI Code Detail

MEDICARE: MS. JESSICA MANGAN

MEDICARE: MS. JESSICA MANGAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor178018186IL
2101Y00000XCounselor178018186IL

General Provider Information

NPI Number : 1841925955
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JESSICA MANGAN
Provider Business Mailing Address
First Line : 414 PLAZA DR STE 301
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5508
Country : US
Telephone Number : 630-728-1744
Fax Number :
Provider Business Practice Location Address
First Line : 414 PLAZA DR STE 301
Second Line :
City : WESTMONT
State : IL
Zip : 60559-5508
Country : US
Telephone Number : 630-728-1744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2022
Last Update Date : 04/08/2026

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Directions to “ MS. JESSICA MANGAN ” Practice Location

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