Provider Demographics
NPI:1710151675
Name:REIS, BRADY JILL (MD)
Entity Type:Individual
Prefix:
First Name:BRADY
Middle Name:JILL
Last Name:REIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRADY
Other - Middle Name:JILL
Other - Last Name:SCHWAB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4901 W. 79TH ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:BURBANK
Mailing Address - State:IL
Mailing Address - Zip Code:60459-1554
Mailing Address - Country:US
Mailing Address - Phone:708-422-0600
Mailing Address - Fax:708-229-6078
Practice Address - Street 1:4901 W. 79TH ST
Practice Address - Street 2:SUITE 10
Practice Address - City:BURBANK
Practice Address - State:IL
Practice Address - Zip Code:60459-1554
Practice Address - Country:US
Practice Address - Phone:708-422-0600
Practice Address - Fax:708-229-6078
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036119376207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILR02041Medicare PIN