MEDICARE: CAITLYN RYBA

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	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1215693528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAITLYN RYBA

Provider Business Mailing Address
First Line	:	326 JOLIET ST
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-3142
Country	:	US
Telephone Number	:	630-876-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 JOLIET ST
Second Line	:
City	:	WEST CHICAGO
State	:	IL
Zip	:	60185-3142
Country	:	US
Telephone Number	:	630-876-6200
Fax Number	:

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

Provider Enumeration Date	:	11/10/2021
Last Update Date	:	11/10/2021

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Directions to “ CAITLYN RYBA ” Practice Location

Language	Start Address	Practice Location

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