Provider Demographics
NPI:1376812453
Name:RYAN BRINKA P.C.
Entity Type:Organization
Organization Name:RYAN BRINKA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BRINKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-761-8566
Mailing Address - Street 1:940 W WILSON ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-1606
Mailing Address - Country:US
Mailing Address - Phone:630-761-8566
Mailing Address - Fax:
Practice Address - Street 1:940 W WILSON ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-1606
Practice Address - Country:US
Practice Address - Phone:630-761-8566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.009752111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203747Medicare PIN