Individual
KAISI GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
904 W TEMPLE AVE, EFFINGHAM, IL 62401-2178
(217) 342-1234
(217) 342-1230
Mailing address
PO BOX 372, MATTOON, IL 61938-0372
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041424158
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209028839
IL
Other
Enumeration date
05/02/2023
Last updated
05/08/2026
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