Individual
DR. THEODORE J LILLEHEI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 SMITH AVE N STE 311, SAINT PAUL, MN 55102-2465
(651) 330-3656
(651) 340-1160
Mailing address
280 SMITH AVE N, SUITE 311, SAINT PAUL, MN 55102-2424
(651) 330-3656
(651) 340-1160
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
29143
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
626878100
—
MN
Enumeration date
02/16/2006
Last updated
02/28/2014
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