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Individual

RYAN KUTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2940 ROLLINGRIDGE RD STE 201, NAPERVILLE, IL 60564-4217
(630) 967-6000
(630) 428-3971
Mailing address
PO BOX 713260, CHICAGO, IL 60677-1260
(630) 469-9200

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
125-071994
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036-155901
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
125-071994
IL STATE MEDICAL LICENSE NUMBER
IL
05
F400984921
IL
Enumeration date
05/21/2018
Last updated
08/11/2023
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