Individual
KENISHA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 S PAULINA ST STE 438, CHICAGO, IL 60612-3808
(312) 563-9196
Mailing address
1053 W 108TH PL, CHICAGO, IL 60643-3724
(773) 208-8195
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
IL
Other
Enumeration date
06/12/2025
Last updated
06/12/2025
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