Individual provider Active NPI

Brenda Ann Reilly, APN

  • Psychiatric/Mental Health Nurse Practitioner
  • Elgin, IL
National Provider Identifier
1255772471
Registry record updated Sep 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209.018199 Issued in IL
Practice address
1845 Grandstand PL
Elgin, IL 60123-6603
Phone
(847) 695-0484
NPI assigned
Jul 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209.018199 IL Primary

Addresses

Primary practice location

1845 Grandstand PL
Elgin, IL 60123-6603

Mailing address

1322 Hill Rd
Geneva, IL 60134-1656
Phone (630) 232-4508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181019001729 IL Practitioner - Nurse Practitioner 8527311687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1845 Grandstand PL
Elgin, IL 60123-6603
Phone (847) 695-0484

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.018199ILMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ecker Center for Behavioral Health Current Accepting new patients
Ecker Center for Behavioral Health CurrentSince Sep 18, 2018 Accepting new patients
Ecker Center for Behavioral Health CurrentSince Sep 18, 2018 Accepting new patients

Locations

1845 Grandstand Pl
Elgin, IL 60123

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1255772471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1322 HILL RD",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601341656",
            "telephone_number": "630-232-4508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1845 GRANDSTAND PL",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601236603",
            "telephone_number": "847-695-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "BRENDA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-16",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209.018199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

Verify at the official NPI Registry.