Provider Demographics
NPI:1982918496
Name:RYAN, CATHERINE JEAN (PHD, RN, APN, CCRN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JEAN
Last Name:RYAN
Suffix:
Gender:F
Credentials:PHD, RN, APN, CCRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:845 S DAMEN AVE
Mailing Address - Street 2:MC 802 ROOM 744
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3727
Mailing Address - Country:US
Mailing Address - Phone:312-996-2180
Mailing Address - Fax:312-996-4979
Practice Address - Street 1:845 S DAMEN AVE
Practice Address - Street 2:MC 802 ROOM 744
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3727
Practice Address - Country:US
Practice Address - Phone:312-996-2180
Practice Address - Fax:312-996-4979
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041194116364SC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine