Individual
LILLIAN G SHIVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
270 MAPLE SUMMIT RD, MCDOW BLDG, JERSEYVILLE, IL 62052
(618) 498-7108
(618) 498-7919
Mailing address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-7518
(618) 498-3052
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007743
IL
Other
Enumeration date
12/03/2020
Last updated
11/13/2024
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