| Theresa Cichon Lilly, CRNA | |
|
30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025-4502 | |
| (248) 258-5058 | |
| Not Available |
| Full Name | Theresa Cichon Lilly |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Location | 30200 Telegraph Rd, Bingham Farms, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417913385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 4704123620 (Michigan) | Primary |
| Entity Name | William Beaumont Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811044878 PECOS PAC ID: 9335051093 Enrollment ID: O20040312000217 |
| Entity Name | Superior Anesthetists Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1831144518 PECOS PAC ID: 5890784987 Enrollment ID: O20040512000785 |
| Entity Name | Northwestern Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215106679 PECOS PAC ID: 4486723657 Enrollment ID: O20080514000823 |
| Entity Name | Eastside Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1235365289 PECOS PAC ID: 4486790219 Enrollment ID: O20091008000624 |
| Entity Name | West Michigan Aas Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1295149227 PECOS PAC ID: 9931324076 Enrollment ID: O20140707000372 |
| Mailing Address | Practice Location Address |
|---|---|
| Theresa Cichon Lilly, CRNA 22609 Ardmore Park Dr, St Clair Shores, MI 48081-2020 Ph: () - | Theresa Cichon Lilly, CRNA 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025-4502 Ph: (248) 258-5058 |
James Bandy, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025 Phone: 248-258-5058 | |
Katherine Brege-biland, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025 Phone: 248-258-5058 | |
Jane Andrea Smith, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025 Phone: 313-258-5058 | |
Fernando Medina, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025 Phone: 248-258-5058 | |
Jeffrey Johnson, CRNA Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025 Phone: 248-258-5058 | |
Marion Ozbun, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025 Phone: 248-258-5058 | |
Kathryn Martino-pierce, CRNA Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 30200 Telegraph Rd, Suite 220, Bingham Farms, MI 48025 Phone: 248-258-5058 |