Individual
PATRICIA LYNN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 296-8087
Mailing address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
209017610
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
IL
Enumeration date
06/15/2018
Last updated
06/15/2018
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