Individual
SEAN T LILLE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10210 N 92ND ST, SUITE 203, SCOTTSDALE, AZ 85258-4509
(480) 661-6197
(480) 661-8146
Mailing address
10210 N 92ND ST, SUITE 203, SCOTTSDALE, AZ 85258-4509
(480) 661-6197
(480) 661-8146
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
27453
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47965103
—
AZ
01
—
7492124
AETNA
AZ
01
—
AZ0875140
BLUE CROSS
AZ
Enumeration date
02/09/2006
Last updated
07/09/2007
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