Healthcare Provider Details

I. General information

NPI: 1700831245
Provider Name (Legal Business Name): ANNE HORRIGAN C.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 N LARKIN AVE SUITE 207
JOLIET IL
60435-3438
US

IV. Provider business mailing address

815 N LARKIN AVE SUITE 207
JOLIET IL
60435-3438
US

V. Phone/Fax

Practice location:
  • Phone: 815-207-4200
  • Fax: 815-207-4100
Mailing address:
  • Phone: 815-207-4200
  • Fax: 815-207-4100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code222Z00000X
TaxonomyOrthotist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: