Healthcare Provider Details

I. General information

NPI: 1417759150
Provider Name (Legal Business Name): RYAN MATTHEW SCADUTO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 N BARRINGTON RD
HOFFMAN ESTATES IL
60169-1019
US

IV. Provider business mailing address

205 HARKLERROAD CT
PICKERINGTON OH
43147-7834
US

V. Phone/Fax

Practice location:
  • Phone: 224-299-6939
  • Fax:
Mailing address:
  • Phone: 614-359-3457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: