Provider Demographics
NPI:1609848282
Name:RIGGS, KEVIN BRIAN (PA-C, MPAS)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:BRIAN
Last Name:RIGGS
Suffix:
Gender:M
Credentials:PA-C, MPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2224 BEAUMONT CT
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-6988
Mailing Address - Country:US
Mailing Address - Phone:630-820-5901
Mailing Address - Fax:
Practice Address - Street 1:535 FAIRWAY DR
Practice Address - Street 2:SUITE 107
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3938
Practice Address - Country:US
Practice Address - Phone:630-548-5936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q78661Medicare UPIN
ILK44860Medicare PIN