BRIAN J REILLY (NPI# 1821123977) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821123977 |
| Entity Type | Individual |
| Full Name | BRIAN J REILLY |
| Credential | D.P.M. |
| Practice Address |
2402 E Oakland Ave Suite 5 Bloomington IL 61701-5828 |
| Practice Telephone | 3096635898 |
| Mailing Telephone | 3096635898 |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2009-12-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
016003992 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
016003992 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0000X |
Podiatrist Specialization: Sports Medicine |
016003992 | IL | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0131X |
Podiatrist Specialization: Foot Surgery |
016003992 | IL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE SHIELD PROVIDER # | 60001563 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669712667 | Brian P Reilly | Speech-Language Pathologist | 2635 Tuscarora Ct, W Melbourne, FL 32904-8092 | 2013-02-27 |
| 1457364846 | Brian D. Reilly | Chiropractor | 711 Albert Pike Rd, Hot Springs, AR 71913-4143 | 2006-08-15 |
| 1992321293 | Brian Thomas Reilly | Otolaryngology | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-06-23 |
| 1538589502 | Brian Gerard Reilly | Pediatrics | 1 Perkins Sq, Akron, OH 44308-1063 | 2014-04-17 |
| 1942440367 | Brian T Reilly | Physical Therapist | 2400 13th St, Ashland, KY 41102-4510 | 2009-02-25 |
| 1497911184 | Brian K Reilly | Otolaryngology | 111 Michigan Ave Nw, Department of Otolaryngology, Washington, DC 20010-2916 | 2008-08-01 |
| 1386677433 | Brian Joseph Reilly | Family Medicine | 590 Court St, Keene, NH 03431-1719 | 2006-07-09 |
| 1770514309 | Brian Peter Reilly | Anesthesiology | 100 Grand St, New Britain, CT 06052-2016 | 2006-07-05 |
| Street Address |
2402 E OAKLAND AVE SUITE 5 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-5828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396862447 | Raymond E Stidd | Podiatrist | 115 E 2nd St, Bloomington, IN 47401-5187 | 2007-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558703298 | Audey Nasser | Podiatrist | 1475 E Belvidere Rd Ste 202, Grayslake, IL 60030-2015 | 2013-07-23 |
| 1588008692 | Podiatry Care, Inc | Podiatrist | 832 Old Checker Rd, Buffalo Grove, IL 60089-1689 | 2013-04-19 |
| 1952600058 | Magdala Danielle Lafontant | Podiatrist | 6374 N Lincoln Ave Ste 205, Chicago, IL 60659-1283 | 2011-03-15 |
| 1679760821 | Foot and Ankle Inc | Podiatrist | 14539 S Stirrup Ct, Homer Glen, IL 60491-9297 | 2007-10-02 |
| 1255548202 | Dr. Robert L. Baron | Podiatrist | 60 Main St., Suite A, Oswego, IL 60543-8594 | 2007-05-17 |
| 1780801548 | Edgewater Beach Foot and Ankle Center, P.C. | Podiatrist | 5331 N Sheridan Rd, Chicago, IL 60640-2531 | 2007-04-20 |
| 1841310760 | Jeffrey Garrard | Podiatrist | 6225 Dempster St, Morton Grove, IL 60053-2818 | 2007-04-02 |
| 1255468054 | Michael Anthony Walsh | Podiatrist | 9806 Grand Ave, Franklin Park, IL 60131-2679 | 2007-02-27 |
| 1659407781 | Martin Bruce Nead | Podiatrist | 1014 E St, Charleston, IL 61920-2524 | 2007-02-25 |
| 1316089378 | William A. Mohs | Podiatrist | 1760 W. Algonquin Rd., Hoffman Estates, IL 60192-1573 | 2007-02-13 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
Please comment or provide details below to improve the information on BRIAN J REILLY.
| 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.