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Ryan Lee Basden Valid NPI

Individual provider · Sports Medicine (Preventive Medicine) Physician · Aurora, IL

NPI
1043715899
Type
Individual (Type 1)
Primary specialty
Sports Medicine (Preventive Medicine) Physician (Preventive Medicine)
Specialty group
Allopathic & Osteopathic Physicians
Taxonomy code
2083S0010X
License number
2083S0010X (IL)
Sex
Male
Sole proprietor
No
Enumerated
2018-03-26
Last updated
2018-03-26
Practice location
347 S Gladstone Ave
Aurora, IL 60506-4877
(618) 973-0615

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