Individual
DR. CLODAGH THERESE RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1400 W 47TH ST STE 1, LA GRANGE, IL 60525-6148
(708) 571-2272
(281) 667-0104
Mailing address
1400 W 47TH ST STE 1, LA GRANGE, IL 60525-6148
(708) 571-2272
(281) 667-0104
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036120989
IL
390200000X
Student in an Organized Health Care Education/Training Program
125049455
IL
Other
Enumeration date
05/16/2007
Last updated
02/13/2020
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