Ryan D Lee, ATC
Individual provider Active NPI Athletic Trainer · Plano, IL
NPI 1649659434 · NPPES record last updated May 26, 2015
Key facts
- NPI
- 1649659434
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 096003941 (IL)
- Practice address
- 903 Appaloosa TRL
Plano, IL 60545-2102 - Phone
- (630) 333-5562
- NPI assigned
- May 26, 2015
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 096003941 | IL | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 096003941 | IL | Yes |
Addresses
Primary practice location
903 Appaloosa TRL
Plano, IL 60545-2102
Mailing address
903 Appaloosa TRL
Plano, IL 60545-2102
Phone (630) 333-5562
Other providers in Plano, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.