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Individual

JENNIFER LEANN GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2045 W GRAND AVE STE B, CHICAGO, IL 60612-1577
(708) 630-1534
(888) 517-8619
Mailing address
3741 WILL SCARLET RD, WINSTON SALEM, NC 27104-1648
(252) 414-0881

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0010-01769
NC

Other

Enumeration date
05/26/2009
Last updated
01/06/2026
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