Provider Demographics
NPI:1205095684
Name:HARRIS, ANTHONY NATHANIEL (MD, MBA, MPH)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:NATHANIEL
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD, MBA, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W ADAMS ST STE 835
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-5182
Mailing Address - Country:US
Mailing Address - Phone:312-762-2959
Mailing Address - Fax:
Practice Address - Street 1:300 W ADAMS ST STE 835
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-5182
Practice Address - Country:US
Practice Address - Phone:312-762-2959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072562A2083P0500X
IL0361320112083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine