MEDICARE: MEGAN ELIZABETH RYAN CRNA

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	367500000X	Certified Registered Nurse Anesthetist		IL

General Provider Information

NPI Number	:	1992980528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN ELIZABETH RYAN CRNA

Provider Business Mailing Address
First Line	:	1337 N HOYNE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-3020
Country	:	US
Telephone Number	:	773-489-0020
Fax Number	:

Provider Business Practice Location Address
First Line	:	1337 N HOYNE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-3020
Country	:	US
Telephone Number	:	773-489-0020
Fax Number	:

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

Provider Enumeration Date	:	01/02/2008
Last Update Date	:	01/03/2008

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