Individual
RYAN CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1460 N HALSTED ST STE 402, CHICAGO, IL 60642-2607
(312) 227-2800
Mailing address
1460 N HALSTED ST STE 402, CHICAGO, IL 60642-2607
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036148259
IL
Other
Enumeration date
03/22/2016
Last updated
09/25/2020
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