person
Mrs. Debra D Mangrum, NP
Adult Health Nurse Practitioner in Olympia Fields, Illinois
NPI 1669917654

Debra D Mangrum is an Adult Health Nurse Practitioner based in Chicago, IL and is specialized in Adult Health. Debra D Mangrum practices in Olympia Fields, IL and has the professional credentials of NP. The NPI Number for Debra D Mangrum is 1669917654 and holds a License No. 71007051A (Illinois).

The current practice location address for Debra D Mangrum is 3800 W 203Rd St Ste 204, Olympia Fields, IL and can be reached out via phone at 708-852-2641 and via fax at 708-503-3260. You can also correspond with Debra D Mangrum through the mailing address at 35318 EAGLE WAY, CHICAGO, IL - 60678-1353 (mailing address contact number: 317-528-4800).

Location: 3800 W 203Rd St Ste 204, Olympia Fields, IL, 60678-1353
person
Provider Profile Details
NPI Number
1669917654
Provider Name
Debra D Mangrum
Credential
NP
Provider Entity Type
Individual
Gender
Female
Address
3800 W 203Rd St Ste 204, Olympia Fields, IL, 60678-1353
Phone Number
708-852-2641
Fax Number
708-503-3260
Provider Enumeration Date
12/29/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
300024535 05 IN
institution
Provider Business Practice Location Address Details
Address
3800 W 203Rd St Ste 204
City
State
Zip
60461-1185
Phone Number
708-852-2641
Fax Number
708-503-3260
person
Provider Business Mailing Address Details
Address
3800 W 203Rd St Ste 204
City
State
Zip
60461-1185
Phone Number
708-852-2641
Fax Number
708-503-3260
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
71007051A (Indiana)
Definition
Definition to come...
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