Individual
YIHOODAH Y GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2128 S CENTRAL PARK AVE, CHICAGO, IL 60623-3113
(773) 467-6967
(773) 572-9553
Mailing address
1022 N KEDZIE AVE, CHICAGO, IL 60651-4128
(773) 467-6967
(773) 572-9553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036103929
IL
2084P0800X
Psychiatry Physician
Primary
036103929
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036103929
—
IL
Enumeration date
07/11/2006
Last updated
07/25/2024
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