Green Healthcare Clinic LLC

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

Legal business name

GREEN HEALTHCARE CLINIC LLC

Practice address

4425 W 63Rd St Ste 204
Chicago, IL 60629-5565

Phone

(888) 876-7012

NPI assigned

May 20, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jacinta Green, MD

Title

Owner/Physician

Phone

(815) 937-0552

Specialties & licenses 1

Addresses

Other names 1

• Green Healthcare Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1558310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1558310400000",
    "number": "1013574532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 WOODLEA RD",
            "city": "KANKAKEE",
            "state": "IL",
            "postal_code": "609018199",
            "telephone_number": "815-937-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4425 W 63RD ST STE 204",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606295565",
            "telephone_number": "888-876-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN HEALTHCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-20",
        "last_updated": "2019-05-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JACINTA",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "815-937-0552",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Green Healthcare Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• McKayla Roos Greco
• Kara W Greeley, M.D.
• Meghan Elizabeth Greeley, LCSW
• Siri Atma W Greeley, MD, PHD
• Green Bamboo Acupuncture & Oriental Medicine
• Green Healthcare LTD.
• Green Light Counseling PLLC
• Green Table Talks NFP
• Green Tree Dental LLC
• Aislin Adriana Green

• Cardiovascular Disease Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.