Individual
JALESSIA LYRAY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12251 S 80TH AVE STE 1520, PALOS HEIGHTS, IL 60463-1290
(708) 923-4200
(708) 923-4201
Mailing address
12251 S 80TH AVE STE 1520, PALOS HEIGHTS, IL 60463-1290
(708) 923-4200
(708) 923-4201
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
26-2707834
CO
363A00000X
Physician Assistant
Primary
085011322
IL
Other
Enumeration date
01/12/2017
Last updated
01/12/2026
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