Healthcare Provider Details

I. General information

NPI: 1700707452
Provider Name (Legal Business Name): RYAN J CARLI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 S WOLF RD
HILLSIDE IL
60162-2212
US

IV. Provider business mailing address

7817 DORCHESTER LN
DARIEN IL
60561-4862
US

V. Phone/Fax

Practice location:
  • Phone: 630-856-6360
  • Fax:
Mailing address:
  • Phone: 630-465-2918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: