Provider Demographics
NPI:1487223061
Name:RYAN, SYDNEY M
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:M
Last Name:RYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4028 WAGNER AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:SCHILLER PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60176-2129
Mailing Address - Country:US
Mailing Address - Phone:224-800-2578
Mailing Address - Fax:
Practice Address - Street 1:15 SPINNING WHEEL RD STE 406
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-5400
Practice Address - Country:US
Practice Address - Phone:773-312-3612
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health