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NPI Code Detail

MEDICARE: DR. RYAN FINKENBINE MD

MEDICARE:  DR. RYAN  FINKENBINE  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084F0202XForensic Psychiatry Physician036.122168IL
22084P0800XPsychiatry Physician036.122168IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CA7030OTHERWVRAILROAD MEDICARE GRP #
3260045229OTHERWVRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508830969
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RYAN FINKENBINE MD
Provider Business Mailing Address
First Line : 221 NE GLEN OAK AVE
Second Line : 7 WEST
City : PEORIA
State : IL
Zip : 61636-0001
Country : US
Telephone Number : 309-671-8393
Fax Number :
Provider Business Practice Location Address
First Line : 221 NE GLEN OAK AVE
Second Line : 7 WEST
City : PEORIA
State : IL
Zip : 61636-0001
Country : US
Telephone Number : 309-671-8393
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 01/22/2009

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Directions to “ DR. RYAN FINKENBINE MD” Practice Location

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