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General NPI Number Information
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NPI Number | 1669325452
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Entity Type | Individual
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Provider Name | RYAN L GREENE
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Gender | Male
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 4600 3RD ST
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City | MOLINE
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State | IL
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Zip | 61265-6106
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Country | US
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Telephone | 309-779-3000
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Fax | 309-779-2167
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Provider Business Mailing Address
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Address Line | 624 14TH AVE
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City | HAMPTON
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State | IL
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Zip | 61256-9602
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Country | US
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Telephone | 309-230-2606
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | IL
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