Individual
DR. RYAN MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2400 N ROCKTON AVE, ROCKFORD, IL 61103-3655
(815) 971-5000
Mailing address
101 OXFORD RD, LANSDALE, PA 19446-4763
(215) 527-0571
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036.144123
IL
207L00000X
Anesthesiology Physician
288918
NY
207L00000X
Anesthesiology Physician
OS015922
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0308137
—
NJ
05
—
036144123
—
IL
05
—
102723767
—
PA
05
—
1659511202
—
WI
Enumeration date
02/23/2009
Last updated
07/21/2022
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