Ryan Philip Collins

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Homer Glen, IL

NPI 1902240252 · NPPES record last updated Apr 17, 2013

Key facts

NPI
1902240252
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
14564 S Mallard LN
Homer Glen, IL 60491-9269
Phone
(708) 712-3076
NPI assigned
Apr 17, 2013
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

14564 S Mallard LN
Homer Glen, IL 60491-9269

Mailing address

14564 S Mallard LN
Homer Glen, IL 60491-9269
Phone (708) 712-3076

Other providers in Homer Glen, IL

All providers in Homer Glen, IL · Student in an Organized Health Care Education/Training Program in Illinois

Sources for this page

Verify at the official NPI Registry.