Dr. Ryan Bernard Mitacek
Pediatric Rheumatologist
5841 S Maryland Ave # Mc5044
Chicago
, Illinois 60637-1443
Dr. Ryan Bernard Mitacek
Pediatric Rheumatologist
5841 S Maryland Ave # Mc5044
Chicago
, Illinois 60637-1443
(773) 702-1150
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About
Features
Specialties
- Pediatric Rheumatologist
Languages spoken
- English
Location
First Address
- Dr. Ryan Bernard Mitacek
- 180 Harvester Dr Ste 110
- Burr Ridge, IL
- Zip : 60527-4503
- Phone : (773) 702-1150
Second Address
- Dr. Ryan Bernard Mitacek
- 5841 S Maryland Ave # Mc5044
- Chicago, IL
- Zip : 60637-1443
- Phone : (773) 702-1000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0216X | Pediatric Rheumatologist | 036.155959 | IL |
National Provider Identifier
| NPI | 1639674211 |
|---|---|
| Provider Name | Dr. Ryan Bernard Mitacek |
| First Address | Burr Ridge, IL 60527-4503 |
| Second Address | Chicago, IL 60637-1443 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/03/2018 |
| Last Update Date | 20/06/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.