Individual
GENNA HIGBEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
607 N STATE ST, CHICAGO, IL 60654-3834
(312) 929-3720
Mailing address
400 E SOUTH WATER ST APT 2905, CHICAGO, IL 60601-4066
(330) 506-5699
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
046.010910
IL
152W00000X
Optometrist
OEG002979
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
360057D9A
MEDICARE PTAN
PA
Enumeration date
07/18/2014
Last updated
03/21/2018
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