| NPI | 1013574532 |
|---|---|
| Doing Business As | GREEN HEALTHCARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | JACINTA GREEN Owner/Physician 815-937-0552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2019-05-20 |