Individual
MR. RYAN JAMES TACCONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-C
Contact information
Practice address
2127 MIDLANDS CT UNIT 203, SYCAMORE, IL 60178-3173
(815) 758-8106
Mailing address
2127 MIDLANDS CT UNIT 203, SYCAMORE, IL 60178-3173
(815) 758-8106
(815) 758-8108
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209021718
IL
363LF0000X
Family Nurse Practitioner
209021718
IL
Other
Enumeration date
10/09/2020
Last updated
04/27/2021
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