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Individual

DR. DANIEL ROBERT GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP, NP-C

Contact information

Practice address
1235 N MULFORD RD STE 222, ROCKFORD, IL 61107-3879
(815) 397-8400
(815) 229-0050
Mailing address
1235 N MULFORD RD, ROCKFORD, IL 61107-3879
(815) 397-8400
(815) 229-0050

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041357363
IL
163W00000X
Registered Nurse
155120-30
WI
363LF0000X
Family Nurse Practitioner
Primary
209014609
IL

Other

Enumeration date
08/01/2016
Last updated
07/17/2018
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