Individual
DR. CODY MICHAEL RISSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2650 RIDGE AVE, DEPARTMENT OF RADIOLOGY, EVANSTON, IL 60201
(847) 570-2475
(847) 570-2942
Mailing address
2650 RIDGE AVE STE 1223, EVANSTON, IL 60201-1700
(847) 570-2040
(847) 570-5315
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
036.159584
IL
2085B0100X
Body Imaging Physician
036159584
IL
2085R0202X
Diagnostic Radiology Physician
Primary
036159584
IL
208800000X
Urology Physician
11019557A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11019557A
MEDICAL RESIDENCY PERMIT
IN
Enumeration date
06/19/2017
Last updated
03/13/2026
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