Individual
DEBORAH GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
245 S GARY AVE, LOWER LEVEL, BLOOMINGDALE, IL 60108-2228
(630) 893-5230
(630) 893-5837
Mailing address
245 S GARY AVE, LOWER LEVEL, BLOOMINGDALE, IL 60108-2228
(630) 893-5230
(630) 893-5837
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041-162592
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041-162592
RN LICENSE
IL
01
—
209-004691
APN LICENSE
IL
Enumeration date
05/13/2006
Last updated
01/11/2012
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