Individual
KHALILAH GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9222 S PERRY AVE, CHICAGO, IL 60620-1419
(773) 454-8912
Mailing address
9222 S PERRY AVE, CHICAGO, IL 60620-1419
(773) 454-8912
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
IL
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/27/2021
Last updated
02/27/2021
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