Healthcare Provider Details

I. General information

NPI: 1497671358
Provider Name (Legal Business Name): HANNAH HIGGINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3002 GE RD STE 2
BLOOMINGTON IL
61704-2502
US

IV. Provider business mailing address

3002 GE RD STE 2
BLOOMINGTON IL
61704-2502
US

V. Phone/Fax

Practice location:
  • Phone: 309-220-8641
  • Fax:
Mailing address:
  • Phone: 309-220-8641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number242.018408
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: