Provider Demographics
NPI:1588845333
Name:RYAN CENTER FOR HAND THERAPY, P.C.
Entity type:Organization
Organization Name:RYAN CENTER FOR HAND THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOALICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L, CHT
Authorized Official - Phone:815-936-0400
Mailing Address - Street 1:400 S KENNEDY DR
Mailing Address - Street 2:SUITE 500
Mailing Address - City:BRADLEY
Mailing Address - State:IL
Mailing Address - Zip Code:60915-2682
Mailing Address - Country:US
Mailing Address - Phone:815-936-0400
Mailing Address - Fax:815-936-0416
Practice Address - Street 1:400 S KENNEDY DR
Practice Address - Street 2:SUITE 500
Practice Address - City:BRADLEY
Practice Address - State:IL
Practice Address - Zip Code:60915-2682
Practice Address - Country:US
Practice Address - Phone:815-936-0400
Practice Address - Fax:815-936-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056005395261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL6079820001Medicare NSC