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Deactivated NPI 1790787570 Deactivated / Inactive NPI Male Practitioner

Dr. Timothy J Ryan , MD

Specialist • Gurnee, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Timothy Ryan has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 11, 2005
NPI Deactivation Date February 14, 2024
Total Practice Duration ~19 Years of Practice (2005 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Timothy Ryan, MD was a registered Specialist practicing in Gurnee, IL. Throughout an active medical career spanning 19 years, Dr. Ryan provided care at the practice location at 1445 N HUNT CLUB RD until profile deactivation on 2024-02-14.

Practice Location & Contact Primary Location

Practice Address

1445 N Hunt Club Rd
Suite 103

Gurnee, IL 600312603

Telephone 8478562534
Fax 8478568254
Associated Practice Facility / Clinic
🏢 Hak Sung Chung Md Phd Sc Facility NPI 1386630986

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Gurnee, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 31.8 Yrs
State Avg: 38.5 Yrs
Regional Practice Density
11 Specialists

Practicing in Gurnee, IL (1322 Statewide)

Telehealth Adoption Rate
9.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Kara Easton , APN

Nurse Practitioner

NPI 1942445630

Advanced Practice Nurse

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 14, 2024

Record deactivated on February 14, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 1445 N HUNT CLUB RD, SUITE 103, GURNEE, IL 600312603 (Tel: 8478562534)

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Updated Business Mailing Address July 08, 2007

Registered at 1445 N HUNT CLUB RD, SUITE 103, GURNEE, IL 600312603 (Tel: 8478562534)

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Provider Name / Credentials Updated July 08, 2007

Recorded as TIMOTHY RYAN, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Specialist

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Initial NPI Registration & Enumeration August 11, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790787570
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 11, 2005
Last Update: July 08, 2007
Deactivation Date: February 14, 2024

Mailing Address

1445 N Hunt Club Rd, Suite 103

Gurnee, IL 600312603

Phone: 8478562534

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.