Individual
BRIAN J REILLY
Active
Individual
BRIAN J REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016003992
IL
213ER0200X
Radiology Podiatrist
016003992
IL
213ES0000X
Sports Medicine Podiatrist
016003992
IL
213ES0131X
Foot Surgery Podiatrist
016003992
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60001563
BLUE SHIELD PROVIDER #
IL
Enumeration date
02/22/2007
Last updated
12/17/2009
Update your record
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