Mallory Mcmahan, is a
Dietitian, Registered based in Mount Vernon, Illinois. Mallory Mcmahan is licensed to practice in Illinois (license number 164022538) and her current practice location is
14521 N Mccauley Ln, Mount Vernon, Illinois. She can be reached at her office (for appointments etc.) via phone at
(618) 335-2092.
NPI number for Mallory Mcmahan is 1538032719 and her current mailing address is Po Box 18, Dix, Illinois. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1538032719.
Healthcare Provider's Profile
| Full Name | Mallory Mcmahan |
|---|
| Gender | Female |
|---|
| Speciality | Dietitian, Registered |
|---|
| Location | 14521 N Mccauley Ln, Mount Vernon, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1538032719
- Provider Enumeration Date: 09/24/2025
- Last Update Date: 10/24/2025
Medical Identifiers
Medical identifiers for Mallory Mcmahan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1538032719 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 133V00000X | Dietitian, Registered | 164022538 (Illinois) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mallory Mcmahan is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mallory Mcmahan, Po Box 18, Dix, IL 62830-0018 Ph: Not Available | Mallory Mcmahan, 14521 N Mccauley Ln, Mount Vernon, IL 62864-7969 Ph: (618) 335-2092 |
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