Individual
MARY T RIGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
750 E TERRA COTTA AVE STE B, CRYSTAL LAKE, IL 60014-3621
(815) 356-2323
(815) 455-8130
Mailing address
750 E TERRA COTTA AVE STE B, CRYSTAL LAKE, IL 60014-3621
(815) 356-2323
(815) 455-8130
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036-092162
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036092162 1
—
IL
Enumeration date
12/26/2006
Last updated
09/03/2020
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