Individual
JAIMIE C. REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
121 S WILKE RD STE 110, ARLINGTON HEIGHTS, IL 60005-1524
(847) 797-4888
(847) 739-0978
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1845
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085-002904
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085002904
STATE LICENSE
IL
01
—
1417086679
NPI
—
Enumeration date
03/05/2007
Last updated
01/21/2025
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