Individual
RYON MICHAEL HENNESSY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
360 W BUTTERFIELD RD, SUITE 160, ELMHURST, IL 60126-5068
(630) 782-9600
(630) 782-1643
Mailing address
360 W BUTTERFIELD RD, SUITE 160, ELMHURST, IL 60126-5068
(630) 782-9600
(630) 782-1643
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036-093298
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02222323
BCBS
IL
05
—
036093298
—
IL
01
—
200028061
MEDICARE RAILROAD
IL
Enumeration date
08/15/2005
Last updated
12/10/2009
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