Provider Demographics
NPI:1508961129
Name:REILLY, JANET HELEN (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:HELEN
Last Name:REILLY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NORTH HICKS ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-3647
Mailing Address - Country:US
Mailing Address - Phone:847-991-7440
Mailing Address - Fax:847-991-9348
Practice Address - Street 1:500 NORTH HICKS ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-3647
Practice Address - Country:US
Practice Address - Phone:847-991-7440
Practice Address - Fax:847-991-9348
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036064781207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036064781OtherIL
AR1904918OtherFEDERAL DEA
IL036064781OtherIL
690871Medicare ID - Type Unspecified