MEDICARE: RYANN LYNN STOREY MSW, LSW

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	104100000X	Social Worker	150117677	IL

General Provider Information

NPI Number	:	1235099342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYANN LYNN STOREY MSW, LSW

Provider Business Mailing Address
First Line	:	425 W WELLINGTON AVE APT 1S
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5802
Country	:	US
Telephone Number	:	714-423-8443
Fax Number	:

Provider Business Practice Location Address
First Line	:	3907 N DAMEN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-3969
Country	:	US
Telephone Number	:	773-423-8447
Fax Number	:

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

Provider Enumeration Date	:	11/12/2025
Last Update Date	:	11/12/2025

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