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Contact Information

RYAN L BASDEN
347 S GLADSTONE AVE
AURORA, IL60506-4877
 Phone: 618-973-0615
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2083S0010X 84 Physician/Preventive Medicine
Indicates primary specialty

NPI Profile & details for RYAN L BASDEN · (Male)

NPI # 1043715899
Status Active
Credentials
Entity Individual
Enumeration date 03/26/2018
Last updated 03/26/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 2083S0010X
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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