MEDICARE: MR. RYAN MUIR LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	180.017815	IL

General Provider Information

NPI Number	:	1083399026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RYAN MUIR LCPC

Provider Business Mailing Address
First Line	:	1470 SOUTHFIELD DR APT 3
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-5341
Country	:	US
Telephone Number	:	630-930-1657
Fax Number	:

Provider Business Practice Location Address
First Line	:	2124 OGDEN AVE STE 301
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7542
Country	:	US
Telephone Number	:	630-441-6092
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2023
Last Update Date	:	03/24/2026

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