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General NPI Number Information
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NPI Number | 1801244827
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Entity Type | Individual
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Provider Name | RYAN JAMES O'ROURKE MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 1815 E IRELAND RD
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City | SOUTH BEND
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State | IN
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Zip | 46614-2845
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Country | US
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Telephone | 574-647-1700
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Fax | 574-647-7572
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Provider Business Mailing Address
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Address Line | 3245 HEALTH DR STE 100
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City | GRANGER
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State | IN
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Zip | 46530-1380
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Country | US
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Telephone | 574-647-1840
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Fax | 702-734-4900
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 01087518A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 125.068130
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301510024
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 20262
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License Number State | NV
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