Individual
DR. KEVIN MICHAEL RYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5201 W WAR MEMORIAL DR, PEORIA, IL 61615-9222
(309) 282-1002
(309) 282-1003
Mailing address
5201 W WAR MEMORIAL DR, PEORIA, IL 61615-9222
(309) 282-1002
(309) 282-1003
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046010468
IL
Other
Enumeration date
10/17/2011
Last updated
10/17/2011
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