Provider Demographics
NPI:1023677960
Name:LIU, MICHAEL A (MD, MPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:LIU
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 N MICHIGAN AVE STE 1006
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2814
Mailing Address - Country:US
Mailing Address - Phone:312-695-0990
Mailing Address - Fax:312-472-0564
Practice Address - Street 1:645 N MICHIGAN AVE STE 1006
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2814
Practice Address - Country:US
Practice Address - Phone:312-695-0990
Practice Address - Fax:312-472-0564
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-12
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP04706207R00000X
NY316957-01207R00000X
IL036175171207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty