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NPI Code Detail

MEDICARE: KATHLEEN MARY MANGAN

MEDICARE: KATHLEEN MARY 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
1235Z00000XSpeech-Language Pathologist146005728IL

General Provider Information

NPI Number : 1881571545
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARY MANGAN
Provider Business Mailing Address
First Line : 138 N ASHLAND AVE
Second Line :
City : LA GRANGE
State : IL
Zip : 60525-2023
Country : US
Telephone Number : 708-373-1818
Fax Number :
Provider Business Practice Location Address
First Line : 5110 W 24TH ST
Second Line :
City : CICERO
State : IL
Zip : 60804-2948
Country : US
Telephone Number : 708-863-4856
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2025
Last Update Date : 08/16/2025

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Directions to “ KATHLEEN MARY MANGAN ” 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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