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General NPI Number Information
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NPI Number | 1194840108
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Entity Type | Organization
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Legal Business Name | HIGGINS SPORTS AND SPINAL REHAB, S.C.
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 712 HIGGINS ROAD
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City | PARK RIDGE
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State | IL
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Zip | 60068-5716
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Country | US
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Telephone | 847-394-8730
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Fax | 847-384-8732
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Provider Business Mailing Address
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Address Line | 712 HIGGINS ROAD
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City | PARK RIDGE
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State | IL
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Zip | 60068-5716
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Country | US
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Telephone | 847-394-8730
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Fax | 847-384-8732
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Authorized Official
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Title or Position | PRESIDENT
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Name | SCOTT CABRERA
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Credential | D.C.
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Telephone | 847-384-8730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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