Individual
JAKEJRA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1845 GRANDSTAND PL, ELGIN, IL 60123-6603
(815) 508-7834
Mailing address
1325 W LINCOLN HWY APT 408B, DEKALB, IL 60115-5934
(815) 508-7834
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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