Provider Demographics
NPI:1386096311
Name:CAGUIA, RYAN
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:CAGUIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5609 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-5071
Mailing Address - Country:US
Mailing Address - Phone:630-666-2052
Mailing Address - Fax:
Practice Address - Street 1:5609 S ELM ST
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-5071
Practice Address - Country:US
Practice Address - Phone:765-520-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-01
Last Update Date:2024-02-08
Deactivation Date:2019-12-13
Deactivation Code:
Reactivation Date:2024-02-05
Provider Licenses
StateLicense IDTaxonomies
IL056.015735225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist