Individual
ALEXANDER GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, BUILDING 110 ROOM 6286, MAYWOOD, IL 60153-3328
(312) 451-6686
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
036113332
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113332
—
IL
Enumeration date
10/17/2006
Last updated
07/19/2022
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