Individual
KHADIJAH DANIELLE HIGGINBOTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10350 RIDGELAND AVE APT 107, CHICAGO RIDGE, IL 60415-1570
(773) 451-6497
Mailing address
10350 RIDGELAND AVE APT 107, CHICAGO RIDGE, IL 60415-1570
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150115767
IL
Other
Enumeration date
12/03/2025
Last updated
12/03/2025
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