Provider Demographics
NPI:1518350776
Name:LILLIG, MARJORIE (CLD)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:LILLIG
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14905 E GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-9599
Mailing Address - Country:US
Mailing Address - Phone:316-821-8173
Mailing Address - Fax:
Practice Address - Street 1:14905 E GILBERT ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-9599
Practice Address - Country:US
Practice Address - Phone:316-821-8173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula