NPI 1043715899

Ryan Lee Basden

Practitioner Sports Medicine (Preventive Medicine) Physician Aurora, IL

Practice location

Address: 347 S Gladstone Ave, Aurora, IL 60506-4877
Phone: (618) 973-0615
Mailing address: 413 E Harrison St, Morton, IL 61550-1608

Registered specialties

Sports Medicine (Preventive Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2083S0010X Licence 2083S0010X (IL)

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Registry record

NPI: 1043715899
Entity type: Individual
Sex (as registered): Male
NPI issued: 26 Mar 2018
Record last updated: 26 Mar 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.