Individual provider Active NPI

Maura E. Ryan, M.D.

  • Diagnostic Radiology Physician
  • Chicago, IL
National Provider Identifier
1124145743
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-115693 Issued in IL
Practice address
225 E Chicago Ave # 9
Chicago, IL 60611-2991
Phone
(312) 227-4500
Fax
(312) 227-9874
NPI assigned
Mar 26, 2007
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD12282 RI
Neuroradiology Physician 2085N0700X 036-115693 IL
Diagnostic Radiology Physician 2085R0202X 036-115693 IL Primary

Addresses

Primary practice location

225 E Chicago Ave # 9
Chicago, IL 60611-2991

Mailing address

225 East Chicago Ave #9
Ann & Robert H. Lurie Children's Memorial Hospital
Chicago, IL 60611
Phone (312) 227-4500

Other identifiers 1

IdentifierTypeStateIssuer
MD12282OtherRIRI LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081126000600 IL Practitioner - Diagnostic RadiologyPractitioner - Pediatric Medicine 7214037514 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036-115693ILMDNeuroradiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation Diagnostic Radiology CurrentSince Sep 1, 2013 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Sep 1, 2013 Accepting new patients
The Imaging Institute Inc Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#118
Chicago, IL 60611

225 E Chicago Ave
#9
Chicago, IL 60611
Phone (312) 227-4500

251 E Huron St
Chicago, IL 60611

676 N Saint Clair St
Ste 800
Chicago, IL 60611
Phone (312) 695-5753

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

515 Valley View Dr
Ste 201
Moline, IL 61265
Phone (312) 695-0870

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1124145743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVE #9",
            "address_2": "ANN & ROBERT H. LURIE CHILDREN'S MEMORIAL HOSPITAL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "312-227-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 E CHICAGO AVE # 9",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "312-227-4500",
            "fax_number": "312-227-9874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "MAURA",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD12282",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "IL",
            "license": "036-115693",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IL",
            "license": "036-115693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI LICENSE",
            "identifier": "MD12282",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.