Provider Demographics
NPI:1679812192
Name:KERZMAN, RYAN M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:M
Last Name:KERZMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16335 HARLEM AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-2574
Mailing Address - Country:US
Mailing Address - Phone:773-332-7832
Mailing Address - Fax:773-332-7832
Practice Address - Street 1:16335 HARLEM AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-2574
Practice Address - Country:US
Practice Address - Phone:773-332-7832
Practice Address - Fax:773-332-7832
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71008860103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical