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General NPI Number Information
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NPI Number | 1891051751
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Entity Type | Individual
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Provider Name | SHAWN PHILLIP LILLIG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2012
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 135 OAK ST
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City | BONNER SPRINGS
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State | KS
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Zip | 66012-1026
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Country | US
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Telephone | 913-298-0754
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Fax | 913-298-0758
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Provider Business Mailing Address
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Address Line | 135 OAK ST
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City | BONNER SPRINGS
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State | KS
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Zip | 66012-1026
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Country | US
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Telephone | 913-298-0754
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Fax | 913-298-0758
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-37779
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License Number State | KS
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