Organization
ATHLETIC EDGE AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN A RYAN-CEISEL PT (OWNER)
(224) 505-3343
Entity
Organization
Contact information
Practice address
1541 SOUTHRIDGE TRL, ALGONQUIN, IL 60102-6602
(847) 987-0438
Mailing address
1541 SOUTHRIDGE TRL, ALGONQUIN, IL 60102-6602
(847) 987-0438
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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