Individual
JUSTIN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1435 N DEARBORN ST APT 4A, CHICAGO, IL 60610-1562
(312) 219-0079
Mailing address
121 IONE DR UNIT C, SOUTH ELGIN, IL 60177-3301
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
09/10/2020
Last updated
09/11/2020
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