Provider Demographics
NPI:1851675532
Name:CHIN, LILLIAN ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:LILLIAN
Middle Name:ELIZABETH
Last Name:CHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 LOXLEY CT
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1811
Mailing Address - Country:US
Mailing Address - Phone:215-928-0829
Mailing Address - Fax:
Practice Address - Street 1:1 LOXLEY CT
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-1811
Practice Address - Country:US
Practice Address - Phone:215-928-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD009942E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics