Aliyah Mangrum

Physician Assistant · Oak Lawn, IL

Individual Active NPI

NPI number 1407431893

Practice location

4440 W 95TH St
Oak Lawn, IL 60453-2600
Phone
(708) 684-6949
Fax
(708) 684-2675

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NPI record

NPI
1407431893
Entity type
Individual (Type 1)
Enumeration date
March 16, 2021
Last updated
February 20, 2026
Certified
February 20, 2026
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 085-008132 IL
Physician Assistant 363A00000X C0007891 MD

Mailing address

29373 Network Pl
Chicago, IL 60673-1293
Phone
(847) 390-5900

Other practice locations (1)

  • 3328 Old Washington Rd, Waldorf, MD 20602-3204 · (301) 932-4954

About Aliyah Mangrum

Aliyah Mangrum is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 4440 W 95TH St, Oak Lawn, IL 60453-2600. The NPI number 1407431893 was assigned on March 16, 2021 and the record was last updated on February 20, 2026.

Aliyah Mangrum lists 2 licenses in the registry: #085-008132 (IL) for Physician Assistant; #C0007891 (MD) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Aliyah Mangrum?

The NPI number is 1407431893.

What is the phone number of Aliyah Mangrum?

The phone number listed for the practice location is (708) 684-6949.

Where is Aliyah Mangrum located?

4440 W 95TH St, Oak Lawn, IL 60453-2600.

What is the taxonomy code for Aliyah Mangrum?

The primary taxonomy code is 363A00000X – Physician Assistant; 1 more listed above.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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