Provider Demographics
NPI:1184165433
Name:MOSES-KESSLER, RYDER LOUISE (MS, MD)
Entity type:Individual
Prefix:
First Name:RYDER
Middle Name:LOUISE
Last Name:MOSES-KESSLER
Suffix:
Gender:F
Credentials:MS, MD
Other - Prefix:
Other - First Name:RYDER
Other - Middle Name:LOUISE
Other - Last Name:MOSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:401 N MICHIGAN AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-4264
Mailing Address - Country:US
Mailing Address - Phone:312-635-0973
Mailing Address - Fax:312-635-0050
Practice Address - Street 1:401 N MICHIGAN AVE STE 1200
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-4264
Practice Address - Country:US
Practice Address - Phone:312-635-0973
Practice Address - Fax:312-635-0050
Is Sole Proprietor?:No
Enumeration Date:2017-03-19
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.070596208100000X
IL336116425208100000X
IL036157220208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation