Provider Demographics
NPI:1609206648
Name:RYAN, ASHLEY (DC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:KRAMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:411 E CONGRESS PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-6247
Mailing Address - Country:US
Mailing Address - Phone:847-987-5058
Mailing Address - Fax:
Practice Address - Street 1:411 E CONGRESS PKWY STE C
Practice Address - Street 2:
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-6247
Practice Address - Country:US
Practice Address - Phone:847-987-5085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-12
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038012458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor