MEDICARE: DR. AMY S REILLY AU.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	231H00000X	Audiologist	147-001311	IL

General Provider Information

NPI Number	:	1720133424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY S REILLY AU.D.

Provider Business Mailing Address
First Line	:	201 E OGDEN AVE
Second Line	:	STE 126
City	:	HINSDALE
State	:	IL
Zip	:	60521-3633
Country	:	US
Telephone Number	:	630-325-6133
Fax Number	:	630-325-4751

Provider Business Practice Location Address
First Line	:	6222 MAIN ST
Second Line	:
City	:	DOWNERS GROVE
State	:	IL
Zip	:	60516-1908
Country	:	US
Telephone Number	:	630-663-9002
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	05/27/2014

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