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General NPI Number Information
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NPI Number | 1447376132
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Entity Type | Individual
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Provider Name | MONICA C RYAN DNP, APN-BC
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Gender | Female
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 10961 S KEDZIE AVE
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City | CHICAGO
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State | IL
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Zip | 60655-2219
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Country | US
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Telephone | 773-239-9100
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Fax | 773-239-9102
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Provider Business Mailing Address
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Address Line | 15427 THISTLEWOOD DR
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City | ORLAND PARK
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State | IL
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Zip | 60462-3808
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Country | US
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Telephone | 708-349-0695
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209-001874
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License Number State | IL
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