Individual
DR. DANIEL RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-1000
(217) 544-6464
Mailing address
111 OAKWOOD RD, EAST PEORIA, IL 61611-1853
(309) 740-4272
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036-150449
IL
2085R0202X
Diagnostic Radiology Physician
D88503
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D88503
LICENSE
MD
Enumeration date
06/26/2014
Last updated
11/27/2023
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