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Individual

DR. ROSS WAYNE GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
3631 N HARLEM AVE, CHICAGO, IL 60634-2237
(773) 725-2953
Mailing address
3631 N HARLEM AVE, CHICAGO, IL 60634-2237

Taxonomy

Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
016.005502
IL

Other

Enumeration date
04/29/2012
Last updated
04/29/2012
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