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General NPI Number Information
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NPI Number | 1164909172
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Entity Type | Individual
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Provider Name | MADELINE LOUISE RYAN PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 11/27/2025
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Provider Practice Location Address
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Address Line | 11595 N MERIDIAN ST STE 402
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City | CARMEL
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State | IN
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Zip | 46032-6947
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Country | US
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Telephone | 317-706-7246
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Fax | 317-706-3417
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Provider Business Mailing Address
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Address Line | 29943 NETWORK PL
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City | CHICAGO
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State | IL
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Zip | 60673-1299
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Country | US
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Telephone | 317-706-3415
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Fax | 317-706-3417
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 10002488A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 100024888A
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License Number State | IN
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