Individual
MICHAEL J REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
20333 W 151ST ST, OLATHE, KS 66061-5350
(913) 791-4357
(913) 791-4435
Mailing address
PO BOX 716, OVERLAND PARK, KS 66201-0716
(913) 791-4357
(913) 791-4435
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0423611
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100276860A
—
KS
01
—
17552018
BLUE CROSS BLUE SHIELD
—
05
—
203029111
—
MO
Enumeration date
07/21/2005
Last updated
08/08/2011
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