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NPI Code Detail

MEDICARE: BRIANA K RYAN

MEDICARE: BRIANA K RYAN
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
1225400000XRehabilitation Practitioner
2104100000XSocial Worker

General Provider Information

NPI Number : 1861847196
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANA K RYAN
Provider Business Mailing Address
First Line : 3808 N ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-5382
Country : US
Telephone Number : 312-841-9028
Fax Number :
Provider Business Practice Location Address
First Line : 3808 N ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-5382
Country : US
Telephone Number : 312-841-9028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2016
Last Update Date : 11/23/2021

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Directions to “ BRIANA K RYAN ” Practice Location

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