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General NPI Number Information
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NPI Number | 1326099656
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Entity Type | Individual
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Provider Name | LILY J LOU M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1740 W TAYLOR ST
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City | CHICAGO
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State | IL
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Zip | 60612-7232
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Country | US
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Telephone | 312-996-7416
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Fax |
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Provider Business Mailing Address
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Address Line | 3340 PROVIDENCE DR SUITE 366
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City | ANCHORAGE
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State | AK
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Zip | 99508-4616
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Country | US
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Telephone | 907-563-3026
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Fax | 907-562-6445
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036154581
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 036154581
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License Number State | IL
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