Healthcare Provider Details

I. General information

NPI: 1326662495
Provider Name (Legal Business Name): LILIIA HARRIS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 RAINBOW BLVD
KANSAS CITY KS
66160-8500
US

IV. Provider business mailing address

3901 RAINBOW BLVD
KANSAS CITY KS
66160-8500
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-6048
  • Fax:
Mailing address:
  • Phone: 913-588-6048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number94-12588
License Number StateKS
# 3
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number15782
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: