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Organization

GREEN HEALTHCARE CLINIC LLC

Active
Other names
Green Healthcare Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACINTA GREEN MD (OWNER/PHYSICIAN)
(815) 937-0552
Entity
Organization

Contact information

Practice address
4425 W 63RD ST STE 204, CHICAGO, IL 60629-5565
(888) 876-7012
Mailing address
825 WOODLEA RD, KANKAKEE, IL 60901-8199
(815) 937-0552

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary

Other

Enumeration date
05/20/2019
Last updated
05/20/2019
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