Healthcare Provider Details

I. General information

NPI: 1629933387
Provider Name (Legal Business Name): ILANA GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

790 COURT OF BIRCH APT 2
VERNON HILLS IL
60061-2638
US

IV. Provider business mailing address

790 COURT OF BIRCH APT 2
VERNON HILLS IL
60061-2638
US

V. Phone/Fax

Practice location:
  • Phone: 847-421-7986
  • Fax:
Mailing address:
  • Phone: 847-421-7986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: