MEDICARE: FINNBAR HIGGINS FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician	209026040	IL

General Provider Information

NPI Number	:	1467153544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FINNBAR HIGGINS FNP-C

Provider Business Mailing Address
First Line	:	10518 S HOYNE AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60643-2518
Country	:	US
Telephone Number	:	773-818-3579
Fax Number	:

Provider Business Practice Location Address
First Line	:	3405 S HALSTED ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-6707
Country	:	US
Telephone Number	:	312-500-3842
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2023
Last Update Date	:	03/15/2023

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