Provider Demographics
NPI:1073685848
Name:LILJA, CHRISTOPHER S (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:S
Last Name:LILJA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3541 LYNDALE AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-4159
Mailing Address - Country:US
Mailing Address - Phone:612-824-1829
Mailing Address - Fax:612-823-3808
Practice Address - Street 1:3541 LYNDALE AVE S
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-4159
Practice Address - Country:US
Practice Address - Phone:612-824-1829
Practice Address - Fax:612-823-3808
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2022-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN472111N00000X
WACH60066746111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN161897100Medicaid
MN350002371Medicare ID - Type Unspecified
MN161897100Medicaid