MEDICARE: DR. RYAN J ROGERS DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	5901002444	MI

General Provider Information

NPI Number	:	1124381934
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RYAN J ROGERS DPM

Provider Business Mailing Address
First Line	:	9400 S CICERO AVE STE 100
Second Line	:
City	:	OAK LAWN
State	:	IL
Zip	:	60453-2536
Country	:	US
Telephone Number	:	708-424-3201
Fax Number	:	708-424-5001

Provider Business Practice Location Address
First Line	:	32743 23 MILE RD STE 110
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48047-2082
Country	:	US
Telephone Number	:	586-725-3444
Fax Number	:	586-725-0984

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

Provider Enumeration Date	:	06/18/2012
Last Update Date	:	05/18/2025

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