Provider Demographics
NPI:1245249960
Name:BRILLA, ROLAND HC (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ROLAND
Middle Name:HC
Last Name:BRILLA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 SHILOH DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53705-2435
Mailing Address - Country:US
Mailing Address - Phone:608-215-4200
Mailing Address - Fax:
Practice Address - Street 1:210 SHILOH DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-2435
Practice Address - Country:US
Practice Address - Phone:608-215-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI45401-0202084N0400X
IL125-0418032084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology