Provider Demographics
NPI:1962186171
Name:DOLLINS, RYAN ANDREW (CTRS)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:ANDREW
Last Name:DOLLINS
Suffix:
Gender:M
Credentials:CTRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 W KNIGHTSBRIDGE DR APT 2A
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-4812
Mailing Address - Country:US
Mailing Address - Phone:708-426-4434
Mailing Address - Fax:
Practice Address - Street 1:3001 GREENBAY ROAD
Practice Address - Street 2:
Practice Address - City:NORTH CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60064-3048
Practice Address - Country:US
Practice Address - Phone:224-610-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRecreation Therapist