Individual
CHRISTINE LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 660-1616
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(913) 660-1616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-39892
KS
208M00000X
Hospitalist Physician
2024038984
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891113379
—
MO
Enumeration date
04/02/2014
Last updated
09/24/2024
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