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Susan Diane Green
Prosthetic/Orthotic Supplier in Jacksonville, Illinois
NPI 1538843354

Susan Diane Green is a Prosthetic/Orthotic Supplier based in Jacksonville, IL. Susan Diane Green practices in Jacksonville, IL. The NPI Number for Susan Diane Green is 1538843354 and holds a License No. (Illinois).

The current practice location address for Susan Diane Green is 307 E Court St, Jacksonville, IL and can be reached out via phone at 217-370-7852.

Location: 307 E Court St, Jacksonville, IL, 62650-2019
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1538843354
Provider Name
Susan Diane Green
Credential
Provider Entity Type
Individual
Gender
Female
Address
307 E Court St, Jacksonville, IL, 62650-2019
Phone Number
217-370-7852
Fax Number
Provider Enumeration Date
06/12/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
307 E Court St
City
Jacksonville
State
Illinois
Zip
62650-2019
Phone Number
217-370-7852
Fax Number
person
Provider Business Mailing Address Details
Address
307 E Court St
City
Jacksonville
State
Illinois
Zip
62650-2019
Phone Number
217-370-7852
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
Prosthetics Case Management
Taxonomy
1744P3200X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Suppliers
Classification
Prosthetic/Orthotic Supplier
Speciality
-
Taxonomy
335E00000X
License No.
()
Definition
An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
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