Healthcare Provider Details

I. General information

NPI: 1053403832
Provider Name (Legal Business Name): ROBERT C OREILLY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD CHILDREN'S HOSPITAL OF PHILADELPHIA
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

100 E PENN SQ WANAMAKER BLDG 9TH FLOOR
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-3440
  • Fax: 267-425-9552
Mailing address:
  • Phone: 267-425-9538
  • Fax: 267-425-9552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License NumberMD048845L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: