Provider Demographics
NPI:1386516888
Name:LANGEN, PAYTON MIKEL (CHW)
Entity type:Individual
Prefix:
First Name:PAYTON
Middle Name:MIKEL
Last Name:LANGEN
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:985 E 1900 NORTH RD
Mailing Address - Street 2:
Mailing Address - City:TAYLORVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62568-7848
Mailing Address - Country:US
Mailing Address - Phone:217-565-3010
Mailing Address - Fax:
Practice Address - Street 1:730 N PAWNEE ST
Practice Address - Street 2:
Practice Address - City:TAYLORVILLE
Practice Address - State:IL
Practice Address - Zip Code:62568-1400
Practice Address - Country:US
Practice Address - Phone:217-824-4113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker