Individual
CICELY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
53 W JACKSON BLVD STE 1620, CHICAGO, IL 60604-3774
(786) 239-5280
Mailing address
4250 N MARINE DR APT 2132, CHICAGO, IL 60613-1717
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
IL
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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