Provider Demographics
NPI:1912648841
Name:ABRIGO, RYAN JAY EDNACOT (MD)
Entity type:Individual
Prefix:DR
First Name:RYAN JAY
Middle Name:EDNACOT
Last Name:ABRIGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:840 SOUTH WOOD STREET
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS (MC 856)
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-4325
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:840 SOUTH WOOD STREET
Practice Address - Street 2:DEPARTMENT OF PEDIATRICS (MC 856)
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4325
Practice Address - Country:US
Practice Address - Phone:312-996-4185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.1753262080N0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program