Organization Active NPI

Yihoodah Y. Green and Associates, LLC

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1962617258
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
YIHOODAH Y. GREEN AND ASSOCIATES, LLC
Practice address
3955 W Roosevelt Rd
Chicago, IL 60624-4235
Phone
(773) 522-5540
Fax
(773) 522-2449
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Yihoodah Y. Green, M.D.
Title
Member
Phone
(773) 522-5540

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Diagnostic Neuroimaging (Psychiatry & Neurology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084D0003X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

3955 W Roosevelt Rd
Chicago, IL 60624-4235

Mailing address

3955 W Roosevelt Rd
Chicago, IL 60624-4235
Phone (773) 522-5540

National Provider Directory

National Provider Directory

Locations

3955 W Roosevelt Rd
Chicago, IL 60624
Phone (773) 522-5540

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1962617258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3955 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606244235",
            "telephone_number": "773-522-5540",
            "fax_number": "773-522-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3955 W ROOSEVELT RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606244235",
            "telephone_number": "773-522-5540",
            "fax_number": "773-522-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YIHOODAH Y. GREEN AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "YIHOODAH",
        "authorized_official_middle_name": "Y.",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "773-522-5540",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084D0003X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.