Provider Demographics
NPI:1538365150
Name:GREEN, CATHERINE EVE
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:EVE
Last Name:GREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3920 N NOTTINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-2234
Mailing Address - Country:US
Mailing Address - Phone:801-367-2257
Mailing Address - Fax:773-794-4938
Practice Address - Street 1:45 S PARK BLVD
Practice Address - Street 2:SUITE 255
Practice Address - City:GLEN ELLYN
Practice Address - State:IL
Practice Address - Zip Code:60137-6280
Practice Address - Country:US
Practice Address - Phone:630-942-8803
Practice Address - Fax:773-794-4938
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker