Individual provider Active NPI

Khadijah Danielle Higginbotham

  • Social Worker
  • Chicago Ridge, IL
National Provider Identifier
1285597690
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
150115767 Issued in IL
Practice address
10350 Ridgeland Ave Apt 107
Chicago Ridge, IL 60415-1570
Phone
(773) 451-6497
NPI assigned
Dec 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 150115767 IL Primary

Addresses

Primary practice location

10350 Ridgeland Ave Apt 107
Chicago Ridge, IL 60415-1570

Mailing address

10350 Ridgeland Ave Apt 107
Chicago Ridge, IL 60415-1570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
150115767ILMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1285597690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 RIDGELAND AVE APT 107",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10350 RIDGELAND AVE APT 107",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604151570",
            "telephone_number": "773-451-6497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "KHADIJAH",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IL",
            "license": "150115767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.