| Doctor Name: | MARK RYERSON |
| NPI Number: | 1356395875 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 016003397 |
| Business Practice Address: | 125 E Central Rd Arlington Hts, IL - 600052649 |
| Business Phone Number: | 8472550330 |
| Business Fax Number: | 8472551785 |
| Mailing Address: | 125 E Central Rd, ARLINGTON HTS |
| State: | IL |
| Postal Code: | 600052649 |
| Phone Number: | 8472550330 |
| Fax Number: | 8472551785 |
| NPI Enumeration Date: | 05/20/2006 |
| NPI Last Update Date: | 02/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0000X |
| License Number: | 016003397 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Sports Medicine |
| Taxonomy Definition: | |