Brian J Reilly
Radiology Sports Medicine Foot Surgery Primary Podiatric Medicine
2402 E Oakland Ave Suite 5
Bloomington
, Illinois 61701-5828
Brian J Reilly
Radiology Sports Medicine Foot Surgery Primary Podiatric Medicine
2402 E Oakland Ave Suite 5
Bloomington
, Illinois 61701-5828
(309) 663-5898
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About
Features
Specialties
- Primary Podiatric Medicine
- Radiology
- Sports Medicine
- Foot Surgery
Languages spoken
- English
Location
First Address
- Brian J Reilly
- 2402 E Oakland Ave Suite 5
- Bloomington, IL
- Zip : 61701-5828
- Phone : (309) 663-5898
Second Address
- Brian J Reilly
- 2402 E Oakland Ave Suite 5
- Bloomington, IL
- Zip : 61701-5828
- Phone : (309) 663-5898
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213EP1101X | Primary Podiatric Medicine | 016003992 | IL |
| N | 111NR0200X | Radiology | 016003992 | IL |
| N | 213ER0200X | Radiology | 016003992 | IL |
| N | 2081S0010X | Sports Medicine | 016003992 | IL |
| N | 213ES0000X | Sports Medicine | 016003992 | IL |
| N | 213ES0131X | Foot Surgery | 016003992 | IL |
National Provider Identifier
| NPI | 1821123977 |
|---|---|
| Provider Name | Brian J Reilly |
| First Address | Bloomington, IL 61701-5828 |
| Second Address | Bloomington, IL 61701-5828 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/02/2007 |
| Last Update Date | 17/12/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 60001563 | BLUE SHIELD PROVIDER # (01) | IL |
| T38588 | (02) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.