Healthcare Provider Details

I. General information

NPI: 1134756828
Provider Name (Legal Business Name): JOHN DALEY HIGGINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 WAUKEGAN RD STE 110
BANNOCKBURN IL
60015-1836
US

IV. Provider business mailing address

250 S NORTHWEST HWY STE 200
PARK RIDGE IL
60068-4252
US

V. Phone/Fax

Practice location:
  • Phone: 847-914-9096
  • Fax: 847-914-9009
Mailing address:
  • Phone: 847-324-3976
  • Fax: 847-929-1154

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036-179825
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: