Individual
JEFFREY RORDAN CILLIAN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4711 N BROADWAY ST STE 102, CHICAGO, IL 60640-4908
(630) 523-3177
Mailing address
4711 N BROADWAY ST STE 102, CHICAGO, IL 60640-4908
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
178.018777
IL
Other
Enumeration date
01/30/2023
Last updated
01/30/2023
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