Individual
RYAN MAXWELL ANSELMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
303 W INSTITUTE PL STE 300, CHICAGO, IL 60610-3080
(617) 485-7105
Mailing address
303 W INSTITUTE PL STE 300, CHICAGO, IL 60610-3080
(617) 485-7105
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209030282
IL
Other
Enumeration date
11/13/2023
Last updated
12/11/2024
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