Lillian G Shively, PA-C

NPI #1972108280 in Jerseyville, Illinois

Provider Information

NPI Number: 1972108280
Entity Type: Individual
Name: Lillian G Shively, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Dec 3, 2020
Last Updated: Nov 13, 2024

Practice Location

Address: 270 MAPLE SUMMIT RD
Address 2: MCDOW BLDG
City: Jerseyville
State: Illinois
ZIP Code: 62052
Phone: (618) 498-7108

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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