Individual
DR. RYAN G PORTER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3105 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 902-3277
(217) 902-7757
Mailing address
611 W PARK ST, URBANA, IL 61801-2501
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036129856
IL
207Y00000X
Otolaryngology Physician
Primary
125-049495
IL
Other
Enumeration date
07/03/2008
Last updated
04/30/2026
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