Individual
RYAN MATHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
30 N MICHIGAN AVE STE 1610, CHICAGO, IL 60602-3653
(773) 234-7509
Mailing address
6177 N LINCOLN AVE # 197, CHICAGO, IL 60659-2313
(773) 234-7509
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071010711
IL
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/26/2020
Last updated
10/18/2023
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