Individual
AVONA ELOISE GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
3354 BIG PINE TRL STE C, CHAMPAIGN, IL 61822-1412
(217) 373-1500
Mailing address
3354 BIG PINE TRL STE C, CHAMPAIGN, IL 61822-1412
(217) 373-1500
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3345
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3345
UNITED HEALTH CARE
IL
Enumeration date
05/12/2020
Last updated
05/12/2020
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