Individual
ERA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
900 NORTH SHORE DR STE 120, LAKE BLUFF, IL 60044-2225
(847) 615-1698
Mailing address
1843 CLAVEY RD, HIGHLAND PARK, IL 60035-4373
(847) 312-5931
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
150.010448
IL
Other
Enumeration date
01/07/2021
Last updated
01/07/2021
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