MEDICARE: EDEN HORIGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN545351	PA

General Provider Information

NPI Number	:	1497725451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDEN HORIGAN

Provider Business Mailing Address
First Line	:	7649 N EASTLAKE TER
Second Line	:	APT LF
City	:	CHICAGO
State	:	IL
Zip	:	60626-1411
Country	:	US
Telephone Number	:	312-859-4845
Fax Number	:

Provider Business Practice Location Address
First Line	:	2509 E THORNWOOD DR
Second Line	:
City	:	LINDENHURST
State	:	IL
Zip	:	60046-6503
Country	:	US
Telephone Number	:	570-346-7797
Fax Number	:	570-342-9802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	05/28/2019

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Directions to “ EDEN HORIGAN ” Practice Location

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