Provider Demographics
NPI:1801045943
Name:PARTHA, LILLY (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:LILLY
Middle Name:
Last Name:PARTHA
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:DR
Other - First Name:LALITHA
Other - Middle Name:
Other - Last Name:PARTHA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, PHD
Mailing Address - Street 1:3510 HOBSON RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WOODRIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60517-1439
Mailing Address - Country:US
Mailing Address - Phone:630-737-1970
Mailing Address - Fax:
Practice Address - Street 1:3510 HOBSON RD
Practice Address - Street 2:SUITE 303
Practice Address - City:WOODRIDGE
Practice Address - State:IL
Practice Address - Zip Code:60517-1439
Practice Address - Country:US
Practice Address - Phone:630-737-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-13
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198.000773171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist