Individual
DR. MARIANNE ELIZABETH GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1910 N BURLING ST, UNIT A, CHICAGO, IL 60614-5124
(773) 505-9892
Mailing address
1910 N BURLING ST, UNIT A, CHICAGO, IL 60614-5124
(773) 505-9892
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036-086197
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621061
BCBS IL
IL
Enumeration date
08/07/2006
Last updated
08/03/2011
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