MEDICARE: CHRISTOPHER A GREEN MD

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	207X00000X	Orthopaedic Surgery Physician	036-060296	IL

General Provider Information

NPI Number	:	1326048547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER A GREEN MD

Provider Business Mailing Address
First Line	:	1235 N MULFORD RD
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-3879
Country	:	US
Telephone Number	:	815-398-7755
Fax Number	:	815-398-7762

Provider Business Practice Location Address
First Line	:	1235 N MULFORD RD
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-3879
Country	:	US
Telephone Number	:	815-398-7755
Fax Number	:	815-398-7762

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	11/13/2008

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Directions to “ CHRISTOPHER A GREEN MD” Practice Location

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