Provider Demographics
NPI:1093706566
Name:LILLIS, SHANNON MCGUIRE (MS)
Entity Type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:MCGUIRE
Last Name:LILLIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 GILLHAM RD
Mailing Address - Street 2:CHILDREN'S MERCY HOSPITAL- GENETICS
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-4619
Mailing Address - Country:US
Mailing Address - Phone:816-234-3290
Mailing Address - Fax:816-346-1378
Practice Address - Street 1:2401 GILLHAM RD
Practice Address - Street 2:CHILDREN'S MERCY HOSPITAL- GENETICS
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-4619
Practice Address - Country:US
Practice Address - Phone:816-234-3290
Practice Address - Fax:816-346-1378
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS