Provider Demographics
NPI:1932473824
Name:RYAN, DIANE P (M,D)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:P
Last Name:RYAN
Suffix:
Gender:F
Credentials:M,D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 W VAN BUREN ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-5500
Mailing Address - Country:US
Mailing Address - Phone:312-563-2875
Mailing Address - Fax:312-942-3012
Practice Address - Street 1:1700 W VAN BUREN ST
Practice Address - Street 2:SUITE 500
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-5500
Practice Address - Country:US
Practice Address - Phone:312-563-2875
Practice Address - Fax:312-942-3012
Is Sole Proprietor?:No
Enumeration Date:2012-02-24
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-099386207R00000X
IL036099386208M00000X
IN01085017A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist