Active NPI
Anne Mary Ryan
- Clinical Social Worker
- Evanston, IL
National Provider Identifier
1679124168
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.007258
- Practice address
- 2353 Colfax Ter
Evanston, IL 60201-2325 - Phone
- (847) 414-8076
- NPI assigned
- Sep 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.007258 | IL | Primary |
Addresses
Primary practice location
2353 Colfax Ter
Evanston, IL 60201-2325
Mailing address
2353 Colfax Ter
Evanston, IL 60201-2325
Phone (847) 414-8076
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: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191224000574 | IL | Practitioner - Clinical Social Worker | 3375977465 | Practice locations: Evanston, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Social Worker
- Education
- Loyola University of Chicago, Stritch School of Medicine, 1994
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2353 Colfax Ter
Evanston, IL 60201-2325
Phone (847) 414-8076
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.007258 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730332800000",
"number": "1679124168",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2353 COLFAX TER",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602012325",
"telephone_number": "847-414-8076"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2353 COLFAX TER",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602012325",
"telephone_number": "847-414-8076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYAN",
"first_name": "ANNE",
"middle_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-25",
"last_updated": "2024-10-31",
"certification_date": "2024-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.007258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.