Individual
BRIAN JAY REACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 W OAK ST, CARBONDALE, IL 62901-1400
(217) 545-8000
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-099587
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-099587
—
IL
01
—
036099587
IDPA FEE FOR SERVICE
IL
01
—
052910
HEALTH ALLIANCE
IL
01
—
411176
HEALTHLINK
IL
01
—
H04942
BLUE CROSS BLUE SHIELD
IL
01
—
K01261
WPS
IL
Enumeration date
07/11/2005
Last updated
11/10/2021
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