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General NPI Number Information
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NPI Number | 1013561992
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Entity Type | Organization
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Legal Business Name | RYLANDER MEDICAL
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Dates
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Enumeration Date | 07/29/2019
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 1755 PARK ST STE 200
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City | NAPERVILLE
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State | IL
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Zip | 60563-8404
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Country | US
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Telephone | 888-995-0455
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Fax | 888-600-3314
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Provider Business Mailing Address
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Address Line | 1755 PARK STREET STE 200 #1057
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City | NAPERVILLE
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State | IL
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Zip | 60563-1336
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Country | US
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Telephone | 888-995-0455
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Fax | 888-600-3314
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHANNON KNOX
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Credential |
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Telephone | 888-995-0455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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