Individual
RYAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 245-3751
Mailing address
4700 BELMONT RD, DOWNERS GROVE, IL 60515-3220
(630) 881-5881
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164008740
IL
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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