MEDICARE: S. CHRISTINE HILLILA PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	0617	KS
2	103TC0700X	Clinical Psychologist	0617	KS
3	103TC2200X	Clinical Child & Adolescent Psychologist	0617	KS
4	103TF0000X	Family Psychologist	0617	KS
5	103TF0200X	Forensic Psychologist	0617	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	14074031	OTHER	KS	BCBS OF KANSAS CITY

General Provider Information

NPI Number	:	1437214665
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	S. CHRISTINE HILLILA PH.D.

Provider Business Mailing Address
First Line	:	4200 SOMERSET DR
Second Line	:	SUITE 246
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-5217
Country	:	US
Telephone Number	:	913-649-8707
Fax Number	:	913-649-8714

Provider Business Practice Location Address
First Line	:	4200 SOMERSET DR
Second Line	:	SUITE 246
City	:	PRAIRIE VILLAGE
State	:	KS
Zip	:	66208-5217
Country	:	US
Telephone Number	:	913-649-8707
Fax Number	:	913-649-8714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	09/11/2025

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Directions to “ S. CHRISTINE HILLILA PH.D.” Practice Location

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