Individual
LAURA RYAN HEYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(888) 824-0200
Mailing address
1503 N MOHAWK ST # 4E, CHICAGO, IL 60610-3038
(763) 228-7098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA100193
MA
363AS0400X
Surgical Physician Assistant
Primary
085006956
IL
Other
Enumeration date
03/06/2019
Last updated
11/20/2025
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