MEDICARE: MR. RYAN JOSEPH HIGGINS LCPC

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	101YP2500X	Professional Counselor	180007557	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	180007557	OTHER	IL	STATE LICENSE

General Provider Information

NPI Number	:	1639484389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RYAN JOSEPH HIGGINS LCPC

Provider Business Mailing Address
First Line	:	53 W JACKSON BLVD STE 1522
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60604-3761
Country	:	US
Telephone Number	:	630-301-8648
Fax Number	:	888-940-2010

Provider Business Practice Location Address
First Line	:	53 W JACKSON BLVD STE 1522
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60604-3761
Country	:	US
Telephone Number	:	312-360-1983
Fax Number	:	312-360-1984

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

Provider Enumeration Date	:	08/18/2010
Last Update Date	:	10/24/2025

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