Individual
ELIANA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1957 W DICKENS AVE, CHICAGO, IL 60614-3934
(773) 789-9640
Mailing address
3400 N LAKE SHORE DR APT 1C, CHICAGO, IL 60657-2802
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242004238
IL
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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