GREEN HEALTHCARE CLINIC LLC (NPI# 1013574532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013574532 |
| Entity Type | Organization |
| Organization Name | GREEN HEALTHCARE CLINIC LLC |
| Practice Address |
4425 W 63rd St Ste 204 Chicago IL 60629-5565 |
| Mailing Address |
825 Woodlea Rd Kankakee IL 60901-8199 |
| Practice Telephone | 8888767012 |
| Mailing Telephone | 8159370552 |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |
| Authorized Official Name | DR. JACINTA GREEN (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 8159370552 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Green Healthcare Clinic | Doing Business As Name - Organization |
| Street Address |
4425 W 63RD ST STE 204 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60629-5565 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982830238 | Jacinta Green | Internal Medicine | 4425 W 63rd St Ste 204, Chicago, IL 60629-5565 | 2009-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053946392 | T & M Care LLC | In Home Supportive Care | 7230 S Talman, Apt 4, Chicago, IL 60629 | 2020-03-06 |
| 1841847811 | Jacqueline Ann Milton | Technician | 6720 South Keating, Chicago, IL 60629 | 2019-08-23 |
| 1194202085 | Andrea Mosqueda | Counselor | 4217 W 59th St, Chicago, IL 60629 | 2018-07-23 |
| 1316439235 | Saliha Awais | Dentist | 5521 S. Kedzie Ave. Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1356833255 | Irfana Ilyas | Dentist | 2403,5521 S Kedzie Ave, Suite 105, Chicago, IL 60629 | 2018-06-06 |
| 1427547538 | Holy Cross Hospital | Psychiatric Unit | 2701 West 68th Street, Chicago, IL 60629 | 2018-05-03 |
| 1871003715 | Siddhi Vinayak Dental | Clinic/Center | 5521 S Kedzie Ave, Unit 105, Chicago, IL 60629 | 2017-10-05 |
| 1477092328 | Debra Shepard | Social Worker | 2601 W. Marquette Rd., Catholic Charities, Chicago, IL 60629 | 2017-02-13 |
| 1255777108 | Jacquelyn Jones | Developmental Therapist | 3108 West Marquette Road Apartment 1-b, Chicago, IL 60629 | 2013-05-20 |
| 1124368030 | Claudia Ballesteros | Interpreter | 5631 S. Richmond, Chicago, IL 60629 | 2013-03-01 |
| Find all providers in zip 60629 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427457399 | Charles Joseph Frahm | Internal Medicine | 1200 E Madison Park, Chicago, IL 60615-2961 | 2014-08-17 |
| 1225447725 | Jeremy R. Estrada | Internal Medicine | 5841 S Maryland Ave # Mc5841, Chicago, IL 60637-1447 | 2014-08-08 |
| 1285049197 | Nidhi Madan | Internal Medicine | 1717 W Congress Pkwy Ste 317, Chicago, IL 60612 | 2014-06-30 |
| 1588097596 | Atif Khawaja Hassan | Internal Medicine | 5140 N California Ave Ste 740, Chicago, IL 60625-7066 | 2013-08-13 |
| 1952651382 | Rajeev Ruben Fernando | Internal Medicine | 365 N Jefferson St, 2712, Chicago, IL 60661-1226 | 2012-09-13 |
| 1174888945 | Mohammad Tarek Kabbany | Internal Medicine | 676 N Saint Clair St Ste 7-730, Chicago, IL 60611-2927 | 2012-07-09 |
| 1740589175 | United Diagnostic Services, LLC | Internal Medicine | 6124 N Milwaukee Ave Ste 2, Chicago, IL 60646-3820 | 2011-03-24 |
| 1932361433 | Sanjay S Gill | Internal Medicine | 2266 N. Lincoln Ave., 3, Chicago, IL 60614 | 2008-06-26 |
| 1053571208 | Curewell Diagnostic Services LLC | Internal Medicine | 6124 N Milwaukee Ave Ste 1, Chicago, IL 60646-3820 | 2008-06-11 |
| 1972760718 | Steve Attanasio | Internal Medicine | 1725 W Harrison St Ste 1159, Chicago, IL 60612 | 2008-05-20 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.