Provider Demographics
NPI:1851557664
Name:CHILELLI, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:CHILELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8737 UNION CENTRE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4878
Mailing Address - Country:US
Mailing Address - Phone:132-322-6635
Mailing Address - Fax:513-645-2234
Practice Address - Street 1:8737 UNION CENTRE BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-4878
Practice Address - Country:US
Practice Address - Phone:132-322-6635
Practice Address - Fax:513-645-2234
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135345207X00000X
OH35.140850207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400139861Medicare PIN