Individual provider Active NPI

Eilis Ryan, MD

  • Emergency Medicine Physician
  • Maywood, IL
National Provider Identifier
1487993911
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036087253 Issued in IL
Practice address
2160 S 1St Ave
Maywood, IL 60153-3328
Phone
(708) 216-9000
NPI assigned
Feb 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent Medicine (Internal Medicine) Physician 207RA0000X 036087253 IL
Emergency Medicine Physician 207P00000X 036087253 IL Primary

Addresses

Primary practice location

2160 S 1St Ave
Maywood, IL 60153-3328

Mailing address

128 Harvest Xing
Orland Park, IL 60467-7382
Phone (708) 364-7465

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eryan107346@direct.luhs.org Direct

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
I20150318002035 IL Practitioner - Emergency MedicinePractitioner - Internal Medicine 7416274089 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

2160 S 1St Ave
Maywood, IL 60153-3328
Phone (708) 216-9000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Loyola University Medical Center CurrentSince Nov 17, 2022 Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Apr 7, 2018 Accepting new patients
Physicians Immediate Care North Chicago LLC CurrentSince Feb 16, 2016 Accepting new patients
Gottlieb Community Health Services Corporation CurrentSince Apr 7, 2018 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Loyola Medical Group LLC CurrentSince Jul 1, 2022 Accepting new patients
Loyola University Medical Center CurrentSince Nov 17, 2022 Accepting new patients
Fastrac Medical, P.C. Emergency Medicine Past Accepting new patients

Locations

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

3231 Euclid Ave
Ste 407
Berwyn, IL 60402
Phone (708) 783-7430

391 S Bolingbrook Dr
Bolingbrook, IL 60440
Phone (630) 226-1006

6800 N Frontage Rd
Burr Ridge, IL 60527
Phone (708) 327-1000

4211 N Cicero Ave
Chicago, IL 60641
Phone (773) 794-1000

750 Essington Rd
Joliet, IL 60435
Phone (815) 729-2160

500 W Court St
Kankakee, IL 60901
Phone (800) 585-4119

125 N La Grange Rd
La Grange, IL 60525
Phone (708) 354-4900

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

2160 S 1st Ave
#150
Maywood, IL 60153

3475 S Alpine Rd
Rockford, IL 61109
Phone (815) 874-8000

2 Westbrook Corporate Ctr
Ste 600
Westchester, IL 60154
Phone (708) 216-5092

Organizations & group practices 8

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1359936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1487993911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 HARVEST XING",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604677382",
            "telephone_number": "708-364-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 S 1ST AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533328",
            "telephone_number": "708-216-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "EILIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-04",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "IL",
            "license": "036087253",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036087253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eryan107346@direct.luhs.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6500 W 65th St",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606384962",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

Verify at the official NPI Registry.