Provider Demographics
NPI:1528586005
Name:LILLY, CHLOE ELIZABETH (DPT)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:ELIZABETH
Last Name:LILLY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5629
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47716-5629
Mailing Address - Country:US
Mailing Address - Phone:502-882-9379
Mailing Address - Fax:502-805-0526
Practice Address - Street 1:3052 BARDSTOWN RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3020
Practice Address - Country:US
Practice Address - Phone:502-454-5544
Practice Address - Fax:502-762-9114
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY007884225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist