Individual provider Active NPI

Susan Marie Ryan, APN ACNP

  • Acute Care Nurse Practitioner
  • Orland Park, IL
National Provider Identifier
1144597758
Registry record updated Nov 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
209.009196 Issued in IL
Practice address
15506 Canterbury LN
Orland Park, IL 60462-4982
Phone
(708) 227-8562
NPI assigned
Nov 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 209.009196 IL Primary

Addresses

Primary practice location

15506 Canterbury LN
Orland Park, IL 60462-4982

Mailing address

15506 Canterbury LN
Orland Park, IL 60462-4982
Phone (708) 227-8562

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.009196ILMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1322352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322352000000",
    "number": "1144597758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15506 CANTERBURY LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624982",
            "telephone_number": "708-227-8562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15506 CANTERBURY LN",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624982",
            "telephone_number": "708-227-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "APN ACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-27",
        "last_updated": "2011-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209.009196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.