Individual
DR. RYAN JAMES JORGENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
PREFERRED PODIATRY GROUP, 425 HUEHL ROAD #13, NORTHBROOK, IL 60062
(847) 504-5000
(847) 504-5015
Mailing address
5689 YORKTOWN TRCE, PLAINFIELD, IN 46168-7428
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07001010A
IN
213E00000X
Podiatrist
884-25
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0732240001
DMERC # WITH PPG
—
05
—
200844950A
—
IN
Enumeration date
06/20/2006
Last updated
02/04/2014
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