MEDICARE: MRS. THEODORA K GREEN LSW, CADC RMA, DVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	150.111842	IL

General Provider Information

NPI Number	:	1255153391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THEODORA K GREEN LSW, CADC RMA, DVA

Provider Business Mailing Address
First Line	:	7 SIMPSON ST # 1A
Second Line	:
City	:	GENEVA
State	:	IL
Zip	:	60134-2459
Country	:	US
Telephone Number	:	312-725-4088
Fax Number	:

Provider Business Practice Location Address
First Line	:	825 CHICAGO AVE FL 2A
Second Line	:
City	:	EVANSTON
State	:	IL
Zip	:	60202-2375
Country	:	US
Telephone Number	:	312-725-4088
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2024
Last Update Date	:	02/19/2026

Similar Medicare Providers

1073704573 — SUNG YONG CHOI
Practice Location Address:

825 CHICAGO AVE , A
EVANSTON, IL
60202-2375

Practice Phone: 847-560-0095
Practice Fax:

1295397669 — BRENDA MARIE REAVIS LCSW
Practice Location Address:

825 CHICAGO AVE FL 2A
EVANSTON, IL
60202-2375

Practice Phone: 312-725-4088
Practice Fax:

1508452434 — ORANGE TREE COUNSELING AND CONSULTING, LLC
Practice Location Address:

825 CHICAGO AVE FL 2A
EVANSTON, IL
60202-2375

Practice Phone: 312-725-4088
Practice Fax:

1427711050 — MICHELE J LAKEMEYER LCSW
Practice Location Address:

825 CHICAGO AVE # 2A
EVANSTON, IL
60202-2375

Practice Phone: 773-207-3838
Practice Fax:

1396405262 — TOGETHER & THROUGH LLC
Practice Location Address:

825 CHICAGO AVE STE 2A
EVANSTON, IL
60202-2375

Practice Phone: 312-324-4419
Practice Fax:

1073335212 — KATELYN A KENNON LSW
Practice Location Address:

825 CHICAGO AVE FL 2A
EVANSTON, IL
60202-2375

Practice Phone: 815-236-0274
Practice Fax:

Directions to “ MRS. THEODORA K GREEN LSW, CADC RMA, DVA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.