Provider Demographics
NPI:1952414179
Name:LIM, LILIAN ELIZABETH ATANACIO (MD)
Entity Type:Individual
Prefix:
First Name:LILIAN ELIZABETH
Middle Name:ATANACIO
Last Name:LIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1186
Mailing Address - Street 2:
Mailing Address - City:PEKIN
Mailing Address - State:IL
Mailing Address - Zip Code:61555-1186
Mailing Address - Country:US
Mailing Address - Phone:309-353-4483
Mailing Address - Fax:309-353-7713
Practice Address - Street 1:530 NE GLEN OAK AVE
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61637-0001
Practice Address - Country:US
Practice Address - Phone:309-685-2485
Practice Address - Fax:309-355-2974
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036116455208000000X
NV178252080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics