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General NPI Number Information
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NPI Number | 1407720709
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Entity Type | Individual
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Provider Name | MCKENNA GREEN
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Gender | Female
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Dates
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Enumeration Date | 10/01/2025
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 155 N MICHIGAN AVE STE 400
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City | CHICAGO
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State | IL
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Zip | 60601-7511
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Country | US
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Telephone | 312-870-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 6410 N HOYNE AVE APT 3E
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City | CHICAGO
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State | IL
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Zip | 60645-5719
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Country | US
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Telephone | 810-588-7754
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | MI
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