Healthcare Provider Details

I. General information

NPI: 1689169971
Provider Name (Legal Business Name): JILL HIGGS OTD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JILL HECHT

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 04/01/2024
Certification Date: 04/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MEDICAL PARK DR STE 100
EFFINGHAM IL
62401-2191
US

IV. Provider business mailing address

PO BOX 372
MATTOON IL
61938-0372
US

V. Phone/Fax

Practice location:
  • Phone: 217-347-3003
  • Fax: 217-347-3005
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number056.012583
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: