MEDICARE: ALYSON MANGIN

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
1	235Z00000X	Speech-Language Pathologist	242008174	IL

General Provider Information

NPI Number	:	1831901214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSON MANGIN

Provider Business Mailing Address
First Line	:	2637 STAR LITE DR
Second Line	:
City	:	JOLIET
State	:	IL
Zip	:	60433-1629
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9624 WILLOW LN
Second Line	:
City	:	MOKENA
State	:	IL
Zip	:	60448-9318
Country	:	US
Telephone Number	:	708-792-3180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	01/23/2025

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Directions to “ ALYSON MANGIN ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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