Reilly, Clarence Raymond

Reilly, Clarence Raymond is an individual health care provider with primary practice located at 800 E Carpenter St , Springfield IL 62769-2402. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Reilly, Clarence Raymond can be contacted via phone (217) 544-6464.

Contact Information

Primary practice address
800 E Carpenter St Springfield IL 62769-2402
Phone: (217) 544-6464
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 85494 Florida
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 036-101510 Illinois

Profile Details

NPI number 1669453338
LBN Legal business name Reilly, Clarence Raymond
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Nov 16th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669453338 NPPES
Florida MEDICAID 265019300

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