Provider Demographics
NPI:1457631442
Name:HIGGINS, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HIGGINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 S MICHIGAN AVE
Mailing Address - Street 2:FLOOR 6
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60603-3200
Mailing Address - Country:US
Mailing Address - Phone:312-592-6823
Mailing Address - Fax:312-592-6801
Practice Address - Street 1:18 S MICHIGAN AVE
Practice Address - Street 2:FLOOR 6
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60603-3200
Practice Address - Country:US
Practice Address - Phone:312-592-6823
Practice Address - Fax:312-592-6801
Is Sole Proprietor?:No
Enumeration Date:2011-08-22
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209008955363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health