Individual
JEFFREY ALLEN GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
12500 AURORA DR, PLEASANT PRAIRIE, WI 53158-1227
(262) 857-5000
(262) 857-5001
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2332
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43026500
—
WI
Enumeration date
01/21/2006
Last updated
09/22/2025
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