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NPI Code Detail

MEDICARE: RYAN C TODD P.T., D.P.T.

MEDICARE: RYAN C TODD P.T., D.P.T.
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
12251G0304XGeriatric Physical Therapist070013594
22251X0800XOrthopedic Physical Therapist070013594IL
3225100000XPhysical Therapist070013594IL

General Provider Information

NPI Number : 1174564744
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN C TODD P.T., D.P.T.
Provider Business Mailing Address
First Line : 852 MADISON ST
Second Line :
City : OAK PARK
State : IL
Zip : 60302-4441
Country : US
Telephone Number : 708-445-3965
Fax Number : 708-445-1355
Provider Business Practice Location Address
First Line : 852 MADISON ST
Second Line :
City : OAK PARK
State : IL
Zip : 60302-4441
Country : US
Telephone Number : 630-933-1500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 03/10/2025

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