Provider Demographics
NPI:1669815593
Name:DOBBS, RYAN WHITNEY
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:WHITNEY
Last Name:DOBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 RANDALL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4219
Mailing Address - Country:US
Mailing Address - Phone:331-732-4600
Mailing Address - Fax:331-732-4602
Practice Address - Street 1:302 RANDALL RD STE 206
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134
Practice Address - Country:US
Practice Address - Phone:331-732-4600
Practice Address - Fax:331-732-4602
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-10
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036153422208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology