Individual
MICHAEL REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
912 NORTHWEST HWY, SUITE 104, FOX RIVER GROVE, IL 60021-1925
(847) 550-9930
(847) 961-6520
Mailing address
912 NORTHWEST HWY, SUITE 104, FOX RIVER GROVE, IL 60021-1925
(847) 550-9930
(847) 961-6520
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036100776
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100776
—
IL
01
—
04932191
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/26/2006
Last updated
07/21/2008
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