Active NPI
Clarence Raymond Reilly, MD
- Diagnostic Radiology Physician
- Springfield, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 036-101510
- Practice address
- 800 E Carpenter St
Springfield, IL 62769-2402 - Phone
- (217) 544-6464
- NPI assigned
- Nov 9, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 85494 | FL | |
| Diagnostic Radiology Physician | 2085R0202X | 036-101510 | IL | Primary |
Addresses
Primary practice location
800 E Carpenter St
Springfield, IL 62769-2402
Mailing address
111 Oakwood Rd
East Peoria, IL 61611-1853
Phone (309) 740-4272
Other practice location 1
1 Good Samaritan Way
Mount Vernon, IL 62864-2402
Phone (618) 242-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 265019300 | Medicaid | FL |
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Indiana University School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Saint Elizabeth Blvd
O Fallon, IL 62269-1099
Phone (618) 234-2120
221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-5522
5200 Reliable Pkwy
Chicago, IL 60686-0052
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Phone (309) 740-4272
530 Neglen Oak Ave
Peoria, IL 61636-0001
Phone (309) 655-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 85494 | FL | MD | Diagnostic Radiology Physician |
| 036-101510 | IL | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Illinois Radiological Associates, LTD. | Diagnostic Radiology | Current | Accepting new patients |
| Kendall Open MRI, LLC | Diagnostic Radiology | Current | Accepting new patients |
| St. Mary's Hospital, Centralia, Illinois | Current | Accepting new patients | |
| St. Mary's Hospital, Centralia, Illinois | Current | Accepting new patients | |
| St. Mary's Hospital, Centralia, Illinois | Diagnostic Radiology | Current | Accepting new patients |
| Indiana University Radiology Associates, Inc. | Diagnostic Radiology | Past | Accepting new patients |
| Prestige Imaging LLC | Diagnostic Radiology | Past | Accepting new patients |
| Cira Michigan PC | Diagnostic Radiology | Past | Accepting new patients |
| SMH Radiology Associates PA | Diagnostic Radiology | Past | Accepting new patients |
| Southern Indiana Radiological Associates Inc | Diagnostic Radiology | Past | Accepting new patients |
Locations
400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221
5200 Reliable Pkwy
Chicago, IL 60686
Phone (309) 671-8748
7420 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-3155
5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060
200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808
530 NE Glen Oak Ave
Peoria, IL 61637
Phone (309) 655-2553
530neglen Oak Ave
Peoria, IL 61636
Phone (309) 685-1054
111 Oakwood Rd
Peoria, IL 61611
Phone (586) 412-4144
800 E Carpenter St
Springfield, IL 62769
Phone (217) 525-5643
Organizations & group practices 10
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.
-
dba Central Illinois Radiological Associates
- Diagnostic Radiology Physician
- Peoria, IL
- NPI 1538192828
-
dba SSM Health St. Mary's Hospital - Centralia
- Emergency Medicine Physician
- Centralia, IL
- NPI 1770687196
Diagnostic Radiology
-
dba SSM Health St. Mary's Hospital - Centralia
- Anesthesiology Physician
- Centralia, IL
- NPI 1477097871
-
dba SSM Health St. Mary's Hospital - Centralia
- Comprehensive Outpatient Rehabilitation Facility (CORF)
- Centralia, IL
- NPI 1710105192
-
- Diagnostic Radiology Physician
- Miami, FL
- NPI 1023028198
-
- Diagnostic Radiology Physician
- Escanaba, MI
- NPI 1972141513
-
- Diagnostic Radiology Physician
- Indianapolis, IN
- NPI 1336192665
-
dba Prestige Imaging at University Groves
- Diagnostic Radiology Physician
- Sarasota, FL
- NPI 1578503165
-
- Diagnostic Radiology Physician
- Sarasota, FL
- NPI 1356323331
-
- Diagnostic Radiology Physician
- Bloomington, IN
- NPI 1346205911
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Memorial Hospital
- General Acute Care Hospital
- Belleville, IL
- NPI 1982796181
-
dba HSHS St. Elizabeth's Hospital
- General Acute Care Hospital
- O'Fallon, IL
- NPI 1629057302
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700092800000",
"number": "1669453338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 OAKWOOD RD",
"city": "EAST PEORIA",
"state": "IL",
"postal_code": "616111853",
"telephone_number": "309-740-4272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E CARPENTER ST",
"city": "SPRINGFIELD",
"state": "IL",
"postal_code": "627692402",
"telephone_number": "217-544-6464"
}
],
"practiceLocations": [
{
"address_1": "1 Good Samaritan Way",
"address_purpose": "LOCATION",
"city": "Mount Vernon",
"state": "IL",
"postal_code": "628642402",
"country_code": "US",
"telephone_number": "618-242-4600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "REILLY",
"first_name": "CLARENCE",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-09",
"last_updated": "2023-11-16",
"certification_date": "2023-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "FL",
"license": "85494",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "IL",
"license": "036-101510",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "265019300",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Springfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.