Individual provider Active NPI

Elizabeth J Mangen, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1780369256
Registry record updated Oct 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085009875 Issued in IL
Practice address
676 N Saint Clair St Ste 940
Chicago, IL 60611-2945
Phone
(312) 926-8358
Fax
(312) 926-9630
NPI assigned
Jun 21, 2023
Last updated
Oct 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085009875 IL Primary
Medical Physician Assistant 363AM0700X 085.009875 IL

Addresses

Primary practice location

676 N Saint Clair St Ste 940
Chicago, IL 60611-2945

Mailing address

676 N Saint Clair St Ste 940
Chicago, IL 60611-2945
Phone (312) 926-8358

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231130002278 IL Practitioner - Physician Assistant 2466800487 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of ChicagoGroup PAC ID 7719899426, 1,674 clinicians

Practice addresses (Care Compare)

5841 S Maryland Ave
Chicago, IL 60637-1443
Phone (888) 824-0200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.009875ILMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Chicago Medical Center CurrentSince Oct 21, 2023 Accepting new patients
The University of Chicago Medical Center CurrentSince Oct 21, 2023 Accepting new patients
University of Chicago CurrentSince Oct 21, 2023 Accepting new patients

Locations

150 Harvester Dr
Ste 300
Burr Ridge, IL 60527
Phone (773) 702-1061

350 N Wall St
Kankakee, IL 60901
Phone (815) 935-7500

120 N Oak St
Oak Brook Mall, IL 60521
Phone (630) 856-6700

Organizations & group practices 3

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792454400000",
    "number": "1780369256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 940",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112945",
            "telephone_number": "312-926-8358",
            "fax_number": "312-926-9630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 N SAINT CLAIR ST STE 940",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112945",
            "telephone_number": "312-926-8358",
            "fax_number": "312-926-9630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANGEN",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2026-10-20",
        "certification_date": "2026-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085009875",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": "085.009875",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.