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General NPI Number Information
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NPI Number | 1407849938
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Entity Type | Individual
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Provider Name | SARAH A GREEN DO
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Gender | Female
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Dates
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Enumeration Date | 08/30/2005
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 20201 CRAWFORD AVENUE
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461
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Country | US
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Telephone | 708-747-4000
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Fax | 866-520-0761
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Provider Business Mailing Address
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Address Line | 4535 DRESSLER ROAD NW
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City | CANTON
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State | OH
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Zip | 44718
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Country | US
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Telephone | 330-493-4443
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Fax | 330-493-8677
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 02002724A
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License Number State | IN
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