Individual
DONTAE GREENFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1027 CLINTON ST, OTTAWA, IL 61350-2039
(773) 885-8917
Mailing address
1027 CLINTON ST, OTTAWA, IL 61350-2039
(773) 885-8917
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147791
—
IL
Enumeration date
06/01/2018
Last updated
06/16/2018
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