Provider Demographics
NPI:1073777041
Name:RYDEN, ARMAND MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ARMAND
Middle Name:MICHAEL
Last Name:RYDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5841 S MARYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1447
Mailing Address - Country:US
Mailing Address - Phone:773-702-1000
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD RRUMC
Practice Address - Street 2:7501
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-267-9643
Practice Address - Fax:310-267-3840
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125051057207R00000X
CAA106925207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACC654ZMedicare PIN