MEDICARE: MONICA C RYAN DNP, APN-BC

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	363LF0000X	Family Nurse Practitioner	209-001874	IL

General Provider Information

NPI Number	:	1447376132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA C RYAN DNP, APN-BC

Provider Business Mailing Address
First Line	:	15427 THISTLEWOOD DR
Second Line	:
City	:	ORLAND PARK
State	:	IL
Zip	:	60462-3808
Country	:	US
Telephone Number	:	708-349-0695
Fax Number	:

Provider Business Practice Location Address
First Line	:	10961 S KEDZIE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60655-2219
Country	:	US
Telephone Number	:	773-239-9100
Fax Number	:	773-239-9102

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

Provider Enumeration Date	:	03/22/2007
Last Update Date	:	03/20/2015

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