MEDICARE: NYLA RIDDICK

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1992638787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NYLA RIDDICK

Provider Business Mailing Address
First Line	:	15725 THOMAS LN
Second Line	:
City	:	OAK FOREST
State	:	IL
Zip	:	60452-3122
Country	:	US
Telephone Number	:	708-762-2907
Fax Number	:

Provider Business Practice Location Address
First Line	:	15725 THOMAS LN
Second Line	:
City	:	OAK FOREST
State	:	IL
Zip	:	60452-3122
Country	:	US
Telephone Number	:	708-762-2907
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

Similar Medicare Providers

1932228012 — ALFRED KARNICKI JR. MD
Practice Location Address:

476 BRIAR LN
LAKE FOREST, IL
60045-3122

Practice Phone: 847-295-2050
Practice Fax:

1669832812 — DR. HIRANGI PATEL O.D.
Practice Location Address:

4601 FOREST DR STE C
COLUMBIA, SC
29206-3122

Practice Phone: 803-787-3080
Practice Fax:

1295017192 — TIM KELLY PHARM D
Practice Location Address:

3122 WHITE OAK TRAIL
HIGHLANDS RANCH, CO
80129

Practice Phone: 720-344-9863
Practice Fax:

1841745940 — DAVID CLISCH DPT
Practice Location Address:

406 W HUDSON AVE
ROYAL OAK, MI
48067-3122

Practice Phone: 734-953-4155
Practice Fax: 734-953-1622

1174455919 — TIFFANY RAY
Practice Location Address:

16150 CICERO AVE STE 12
OAK FOREST, IL
60452-4136

Practice Phone: 708-580-0119
Practice Fax:

1871596817 — HOMER ABIAD M.D.
Practice Location Address:

15900 CICERO AVE
OAK FOREST, IL
60452-4006

Practice Phone: 708-633-4133
Practice Fax: 708-633-3029

Directions to “ NYLA RIDDICK ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.