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Individual

DANIEL GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
109 N ABERDEEN ST, CHICAGO, IL 60607-1668
(630) 368-1771
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.022960
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070-022960
STATE LICENSE
IL
Enumeration date
06/21/2017
Last updated
03/02/2023
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