Individual
MRS. EILEEN THERESE REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
620 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-5581
Mailing address
ATTN: SSM HEALTH FOND DU LAC REGIONAL CLINIC, 1808 W BELTLINE HWY, MADISON, WI 53713-2334
(920) 926-8343
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
71981-20
WI
208M00000X
Hospitalist Physician
Primary
71981-20
WI
208M00000X
Hospitalist Physician
A198590
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700865573
—
WI
Enumeration date
01/11/2006
Last updated
07/16/2025
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