Individual
JOSEPH B LILLEGARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2530 CHICAGO AVE, SUITE 550, MINNEAPOLIS, MN 55404-4289
(612) 813-8606
(612) 813-8005
Mailing address
2530 CHICAGO AVE STE 550, MINNEAPOLIS, MN 55404-4293
(612) 813-8606
(612) 813-8005
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
50054
MN
2086S0120X
Pediatric Surgery Physician
103103
WI
2086S0120X
Pediatric Surgery Physician
Primary
MD451384
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
016990000
—
MN
05
—
35217100
—
WI
05
—
ENROLLED
—
IA
Enumeration date
05/07/2007
Last updated
09/25/2025
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