Individual
LISA ANN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3348 W 87TH ST, CHICAGO, IL 60652-3767
(773) 776-4471
Mailing address
PO BOX 746715, ATLANTA, GA 30374-6715
(773) 776-4471
(773) 564-3510
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.150408
IL
207R00000X
Internal Medicine Physician
4301096278
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710207444
—
MI
Enumeration date
06/04/2010
Last updated
09/16/2025
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