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General NPI Number Information
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NPI Number | 1902795602
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Entity Type | Organization
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Legal Business Name | BIOLIV LLC
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 300 W ADAMS ST STE 835
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City | CHICAGO
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State | IL
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Zip | 60606-5182
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Country | US
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Telephone | 312-999-7654
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W ADAMS ST STE 835
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City | CHICAGO
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State | IL
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Zip | 60606-5182
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Country | US
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Telephone | 312-999-7654
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANTHONY NATHANIEL HARRIS
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Credential | MD, MBA, MPH
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Telephone | 317-340-6682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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