Individual provider Active NPI

Clarence Raymond Reilly, MD

  • Diagnostic Radiology Physician
  • Springfield, IL
National Provider Identifier
1669453338
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
036-101510 Issued in IL
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

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
265019300MedicaidFL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130624000639 IL Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 8022003839 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Indiana University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Illinois Radiological Associates LTDGroup PAC ID 9436061827, 205 clinicians

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

LicenseStateTypeSpecialty
85494FLMDDiagnostic Radiology Physician
036-101510ILMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Illinois Radiological Associates, LTD. Diagnostic Radiology CurrentSince Dec 6, 2025 Accepting new patients
Kendall Open MRI, LLC Diagnostic Radiology CurrentSince May 24, 2004 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jun 1, 2013 Accepting new patients
St. Mary's Hospital, Centralia, Illinois CurrentSince Jun 1, 2013 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.

Hospital & facility affiliations 2

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": "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

Verify at the official NPI Registry.