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Individual

RYLAN MIYAT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CSFA, CSA, SA-C, RSA

Contact information

Practice address
1713 N CAMPBELL AVE APT G, CHICAGO, IL 60647-6718
(309) 530-3407
Mailing address
1713 N CAMPBELL AVE APT G, CHICAGO, IL 60647-6718
(309) 530-3407

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
237000129
IL
363AS0400X
Surgical Physician Assistant
Primary
238.000499
IL

Other

Enumeration date
08/09/2013
Last updated
09/22/2023
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