Individual
DR. BRIAN A MAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
747 N RUTLEDGE ST, 3RD FLOOR, SPRINGFIELD, IL 62702
(217) 545-8000
(217) 545-2588
Mailing address
PO BOX 19653, SPRINGFIELD, IL 62794-9653
(217) 545-8000
(217) 545-2588
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036-138547
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
036-138547
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
2022023885
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036138547
—
IL
Enumeration date
04/17/2008
Last updated
04/08/2026
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