Provider Demographics
NPI:1508156803
Name:HSIEH, LILY (MD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:
Last Name:HSIEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-955-1450
Mailing Address - Fax:414-955-0197
Practice Address - Street 1:745 FLETCHER DR STE 302
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4750
Practice Address - Country:US
Practice Address - Phone:847-695-6600
Practice Address - Fax:847-695-4279
Is Sole Proprietor?:No
Enumeration Date:2011-04-08
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036150488208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1508156803Medicaid