Individual
DR. CHRISTOPHER R GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 MEMORIAL DR, SUITE 220, ALTON, IL 62002-6723
(618) 474-1723
(618) 462-6989
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(618) 474-1723
(618) 462-6989
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-064682
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064682
—
IL
Enumeration date
08/01/2006
Last updated
06/10/2016
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