person
Mr. James Theodore Green SR., LCPC
Professional Counselor in Chicago, Illinois
NPI 1902921299

James Theodore Green SR. is a Professional Counselor based in Chicago, IL and is specialized in Professional. James Theodore Green SR. practices in Chicago, IL and has the professional credentials of LCPC. The NPI Number for James Theodore Green SR. is 1902921299 and holds a License No. (Illinois).

The current practice location address for James Theodore Green SR. is 7400 S Racine Ave, Chicago, IL and can be reached out via phone at 773-874-9715 and via fax at 773-874-9715.

Location: 7400 S Racine Ave, Chicago, IL, 60636-4114
person
Provider Profile Details
NPI Number
1902921299
Provider Name
James Theodore Green SR.
Credential
LCPC
Provider Entity Type
Individual
Gender
Male
Address
7400 S Racine Ave, Chicago, IL, 60636-4114
Phone Number
773-874-9715
Fax Number
773-874-9715
Provider Enumeration Date
03/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
01636560 01 IL BCBS PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
7400 S Racine Ave
City
State
Zip
60636-4114
Phone Number
773-874-9715
Fax Number
773-874-9715
person
Provider Business Mailing Address Details
Address
7400 S Racine Ave
City
State
Zip
60636-4114
Phone Number
773-874-9715
Fax Number
773-874-9715
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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