Individual
MS. KELSEY LYNN GREINER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2211 N OAK PARK AVE, CHICAGO, IL 60707-3392
(773) 622-5400
Mailing address
2211 N OAK PARK AVE, CHICAGO, IL 60707-3392
(773) 622-5400
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
085006040
IL
363AS0400X
Surgical Physician Assistant
Primary
085006040
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085006040
STATE LICENSE
IL
01
—
1137808
NCCPA
—
Enumeration date
10/19/2016
Last updated
02/12/2024
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