Individual
DR. DOUGLAS W LILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2424 S 90TH ST, #310, WEST ALLIS, WI 53227-2455
(414) 328-8700
(414) 328-8864
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
(414) 671-8860
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30235
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31481200
—
WI
Enumeration date
08/23/2006
Last updated
06/05/2025
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