DR. RYAN MANECKE (NPI# 1942289129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942289129 |
| Entity Type | Individual |
| Full Name | DR. RYAN MANECKE |
| Credential | M.D. |
| Practice Address |
1541 Riverboat Center Dr Joliet IL 60431-9341 |
| Practice Telephone | 8154094930 |
| Practice Fax Number | 8157413263 |
| Mailing Telephone | 8154094930 |
| Mailing Fax Number | 8157413263 |
| Enumeration Date | 2006-01-16 |
| Last Update Date | 2017-03-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 036096483 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036096483 | 05 |
| Street Address |
1541 RIVERBOAT CENTER DR |
| City | JOLIET |
| State | IL |
| Zip Code | 60431-9341 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710486063 | Carrie Defuss | Nurse Practitioner | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2018-02-01 |
| 1194188383 | Ryan Lewis | Physician Assistant | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2016-04-04 |
| 1235403130 | Peter Tek | Family Medicine | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2012-02-24 |
| 1013248574 | Elizabeth Ann Bean | Physician Assistant | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2010-01-23 |
| 1831398445 | Constance A Marks | Specialist | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2007-07-13 |
| 1003032293 | Tasha Dawn Horsley | Nurse Practitioner | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2007-04-17 |
| 1588760144 | Vera Petras | Radiology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-09-14 |
| 1164531034 | Sandeep Sawhney | Urology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-08-30 |
| 1396758553 | Advanced Urology Associates Sc | Specialist | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-08-15 |
| 1669400933 | Luke S Cho | Urology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-06-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588173413 | Margaret Ann Silvas | Nurse's Aide | 3627 Woodside Ct, Joliet, IL 60431 | 2017-09-22 |
| 1174900757 | Melissa Suzanne Spoula | Optometrist | 3340 Mall Loop Dr Spc 1442, Joliet, IL 60431 | 2015-05-02 |
| 1154678373 | Melissa J Murphy | Physical Therapist | 852 A Sharp Drive, Provena Therapy and Industrial Rehabilitation Center, Shorewood, IL 60431 | 2012-08-07 |
| 1053540096 | Sarah M Patnoudes | Occupational Therapist | 1035 Heron Circle, Joliet, IL 60431 | 2009-07-13 |
| 1558598649 | Regi Nair | Pharmacy Technician | 1901 Appleman, Joliet, IL 60431 | 2009-06-16 |
| 1346483948 | John A. Propati, Inc. | Clinic/Center | 1401 Illinois Rt. 59, Shorewood, IL 60431 | 2009-04-13 |
| 1467622910 | Cornerstone Home Healthcare LLC | Home Health | 350 Houbolt Rd., Suite 209, Joliet, IL 60431 | 2008-03-11 |
| 1780898098 | Annie Bishop | Home Health Aide | 3806 Brenton Dr, Joliet, IL 60431 | 2007-05-09 |
| 1760601272 | James John Babiuk | Dentist | 3209 Fiday Rd, Joliet, IL 60431 | 2007-04-24 |
| 1689731481 | Smile Street Dental | Dentist | 3587 Hennepin Dr, Joliet, IL 60431 | 2007-01-02 |
| Find all providers in zip 60431 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750369658 | George Thomas Jones IIi | Urology | 2112 W Jefferson St, Suite 222, Joliet, IL 60435-6663 | 2006-01-03 |
| 1386848315 | George T. Jones M.d.s.c | Urology | 2112 W Jefferson St, Suite 222, Joliet, IL 60435-6663 | 2007-06-13 |
| 1528100930 | Associated Urological Specialists | Urology | 812 Campus Dr, Joliet, IL 60435-5128 | 2007-02-13 |
| 1174665509 | Associated Urological Specialists | Urology | 1300 Copperfield Ave, Joliet, IL 60432-2004 | 2007-02-13 |
| 1881782126 | Ernesto Tan, M.d.s.c. | Urology | 2400 Glenwood Ave Ste 210, Joliet, IL 60435-5498 | 2006-10-11 |
| 1164531034 | Sandeep Sawhney | Urology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-08-30 |
| 1669400933 | Luke S Cho | Urology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-06-28 |
| 1386624286 | Thai T Nguyen | Urology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-01-18 |
| 1003896903 | Thomas E Burns | Urology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-01-18 |
| 1023098910 | Gregory A Lewis | Urology | 1541 Riverboat Center Dr, Joliet, IL 60431-9341 | 2006-01-18 |
| Find all providers in JOLIET | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.