Individual provider Active NPI

Ashley Mangin, MOS, OTR/L

  • Occupational Therapist
  • Mokena, IL
National Provider Identifier
1104236710
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056.010554 Issued in IL
Practice address
19100 Crescent Dr
Suite 101
Mokena, IL 60448-7510
Phone
(708) 478-5400
Fax
(708) 478-5300
NPI assigned
May 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 056.010554 IL Primary

Addresses

Primary practice location

19100 Crescent Dr
Suite 101
Mokena, IL 60448-7510

Mailing address

9319 Walnut LN
Tinley Park, IL 60487-5257
Phone (708) 638-2745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
056.010554ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Can DO, Inc. Occupational Therapist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1104236710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9319 WALNUT LN",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604875257",
            "telephone_number": "708-638-2745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19100 CRESCENT DR",
            "address_2": "SUITE 101",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604487510",
            "telephone_number": "708-478-5400",
            "fax_number": "708-478-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGIN",
        "first_name": "ASHLEY",
        "credential": "MOS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056.010554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mokena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.