Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Ryan Bernard Mitacek, MD

Individual provider Pediatrics Physician · NPI 1639674211

Dr. Ryan Bernard Mitacek, MD is a Pediatric Medicine in Chicago, Illinois. Qualified in 2017, 9 years ago. Practices with University Pediatricians, a 128-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois and Michigan.

Years since qualifying
9
Licensed in
IL, MI
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

5841 S Maryland Ave # MC5044
Chicago, IL 60637-1443
Phone: (773) 702-1000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3901 Beaubien St, Detroit, MI 48201-2119 — (313) 745-5870

Specialties & licences

Pediatric Rheumatology Physician (primary) Taxonomy 2080P0216X · Licence 036.155959 (IL)
Pediatrics Physician Taxonomy 208000000X · Licence 4301511663 (MI)

Record details

NPI number1639674211
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 27, 2018
Last updated in NPPESApril 12, 2024
Certification dateApril 12, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice University Pediatricians — 128 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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