Yihoodah Y Green, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036103929 Issued in IL

Practice address

2128 S Central Park Ave
Chicago, IL 60623-3113

Phone

(773) 467-6967

Fax

(773) 572-9553

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Psychiatry

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Healing Hands Resource CenterGroup PAC ID 0143457812, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Healing Hands Resource Center

  • Multi-Specialty Clinic/Center
  • Chicago, IL
  • NPI 1790938249

  IL

  Medicare reassignment Care Compare group NPD
• K.a.M Alliance, Inc.

  • Community/Behavioral Health Agency
  • Chicago, IL
  • NPI 1003046152

  IL, Psychiatry

  Medicare reassignment NPD

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1376578005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1022 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606514128",
            "telephone_number": "773-467-6967",
            "fax_number": "773-572-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2128 S CENTRAL PARK AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606233113",
            "telephone_number": "773-467-6967",
            "fax_number": "773-572-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "YIHOODAH",
        "middle_name": "Y",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036103929",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036103929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036103929",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terri Green, RN
• Thomas Patrick Green, MD
• Tiffany Green, DPT
• Unicka Mare Green
• Valerie Green, LCSW
• Tayler Ann Greenagel, OD
• Evan S Greenbaum, MD
• Jordyn Greenbaum
• Greenbax Health Solutions, LLC
• Avril Greenberg, RD

• All providers in Chicago, IL
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.