Healthcare Provider Details

I. General information

NPI: 1811381049
Provider Name (Legal Business Name): ELIZABETH RYZNAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 01/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

446 E ONTARIO ST SUITE 7-200
CHICAGO IL
60611-4418
US

IV. Provider business mailing address

446 E ONTARIO ST SUITE 7-200
CHICAGO IL
60611-4418
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-8058
  • Fax: 312-926-7612
Mailing address:
  • Phone: 312-926-8058
  • Fax: 312-926-7612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number125067731
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: