Provider Demographics
NPI:1194840108
Name:HIGGINS SPORTS AND SPINAL REHAB, S.C.
Entity Type:Organization
Organization Name:HIGGINS SPORTS AND SPINAL REHAB, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-384-8730
Mailing Address - Street 1:712 HIGGINS ROAD
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60068-5716
Mailing Address - Country:US
Mailing Address - Phone:847-394-8730
Mailing Address - Fax:847-384-8732
Practice Address - Street 1:712 HIGGINS ROAD
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-5716
Practice Address - Country:US
Practice Address - Phone:847-394-8730
Practice Address - Fax:847-384-8732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center