Reilly, Jaimie C.

Reilly, Jaimie C. is an individual health care provider with primary practice located at 1200 W State St , Rockford IL 61102-2112. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Reilly, Jaimie C. can be contacted via phone (815) 490-1600.

Contact Information

Primary practice address
1200 W State St Rockford IL 61102-2112
Phone: (815) 490-1600
Fax: (815) 490-1881
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085-002904 Illinois

Profile Details

NPI number 1417086679
LBN Legal business name Reilly, Jaimie C.
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2007
Last updated Aug 24th, 2022 - about 4 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 1417086679 NPPES
Illinois Other 085002904 STATE LICENSE
Illinois Other 1417086679 STATE LICENSE

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