| Mckenzie K Mangun, PA-C | |
|
401 N Main St, Roanoke, IL 61561-7585 | |
| (309) 923-2661 | |
| (309) 923-7628 |
| Full Name | Mckenzie K Mangun |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 401 N Main St, Roanoke, Illinois |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851074090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 085011710 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mckenzie K Mangun, PA-C 401 N Main St, Roanoke, IL 61561-7585 Ph: (309) 923-2661 | Mckenzie K Mangun, PA-C 401 N Main St, Roanoke, IL 61561-7585 Ph: (309) 923-2661 |
Maddalena Fairchild, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 401 N Main St, Roanoke, IL 61561 Phone: 309-923-2661 | |
Ms. Victoria Gorfin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 401 N Main St, Roanoke, IL 61561 Phone: 309-923-2661 |