Individual
DR. CRAIG LOUIS-ALBERT HIGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614-4686
(309) 683-5600
(309) 683-5607
Mailing address
5114 N GLEN PARK PLACE RD, PEORIA, IL 61614-4686
(309) 683-5600
(309) 683-5607
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-116366
IL
207R00000X
Internal Medicine Physician
MD432119
PA
208000000X
Pediatrics Physician
036-116366
IL
208000000X
Pediatrics Physician
Primary
MD432119
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036116366
—
IL
01
—
809840
MEDICARE GROUP #
IL
01
—
CA4079
RR MEDICARE GROUP PTAN
IL
01
—
P00617108
RR MEDICARE MEMBER PTAN
IL
Enumeration date
05/18/2007
Last updated
09/26/2008
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