Healthcare Provider Details

I. General information

NPI: 1093706566
Provider Name (Legal Business Name): SHANNON MCGUIRE LILLIS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/02/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 GILLHAM RD CHILDREN'S MERCY HOSPITAL- GENETICS
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

2401 GILLHAM RD CHILDREN'S MERCY HOSPITAL- GENETICS
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 816-234-3290
  • Fax: 816-346-1378
Mailing address:
  • Phone: 816-234-3290
  • Fax: 816-346-1378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: