Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SUSAN DIANE GREEN
Active Sole ProprietorSUSAN DIANE GREEN is a Prosthetic/Orthotic Supplier healthcare provider located in JACKSONVILLE, Illinois. NPI 1538843354 is currently active in the NPPES registry. Verify at CMS.
Prosthetic/Orthotic Supplier · JACKSONVILLE, IL
Registration Details
- NPI Number
- 1538843354
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 12, 2023 (3.1945827948017 yrs)
- Last Updated
- Jun 20, 2023
- Sole Proprietor
- Yes
Practice Information
- Address
-
307 E COURT STJACKSONVILLE, IL, 626502019Browse IL providers · Browse ZIP 62650
- Phone
- 2173707852
- Primary Specialty
-
Prosthetic/Orthotic Supplier
335E00000X
- Additional Specialty
- Prosthetic/Orthotic Supplier
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.