MRS. ILEANA GREEN (NPI# 1477042505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477042505 |
| Entity Type | Individual |
| Full Name | MRS. ILEANA GREEN |
| Credential | FNP-C |
| Practice Address |
1400 Broadway Gary IN 46407 |
| Mailing Address |
1400 Broadway Gary IN 46407-1310 |
| Practice Telephone | 2198822305 |
| Mailing Telephone | 2198822305 |
| Mailing Fax Number | 2198821038 |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2019-05-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
28195095A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1400 Broadway, Gary, IN 464071310 | 2198822305 | |
| 2640 Hamstrom Rd, Portage, IN 463683832 | 2197624423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942272828 | Ileana Green | Pathology | 5 Perryridge Rd, Pathology Dept., Greenwich, CT 06830 | 2006-02-03 |
| Street Address |
1400 BROADWAY |
| City | GARY |
| State | IN |
| Zip Code | 46407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477802270 | Planned Parenthood of Indiana Gary | Clinic/Center | 1124 Broadway, Gary, IN 46407 | 2012-09-07 |
| 1891930913 | Angela Juanita Anderson | General Practice | 2353 Madison Street, Gary, IN 46407 | 2008-12-03 |
| 1548470537 | Rae Emerick | Speech-Language Pathologist | 2350 Taft Street, Gary, IN 46407 | 2007-05-22 |
| 1467577049 | Lavearn May | Registered Nurse | 308 E. 21st Avenue, Gary, IN 46407 | 2007-03-20 |
| 1881719532 | Kenneth Hicks | Social Worker | 308 East 21st Avenue, Gary, IN 46407 | 2007-03-20 |
| 1356476287 | Chube Medical Corporation | Family Medicine | 1701 Broadway, Gary, IN 46407 | 2007-02-22 |
| 1346263217 | Pulaski Memorial Hospital | Nursing Facility/Intermediate Care Facility | 700 E 21st Ave, Gary, IN 46407 | 2006-07-25 |
| 1275734949 | Kenneth Edward Anderson | Speech-Language Pathologist | 2350 Taft St, Timberview Health Care Center, Gary, IN 46407 | 2007-05-30 |
| 1669555991 | David D Chube Sr. | Family Medicine | 1701 Broadway, Gary, IN 46407 | 2006-10-23 |
| 1093261992 | Millennium Ultrasound LLC | Spec/Tech, Cardiovascular | 1149 Polk St, Gary, IN 46407-1120 | 2016-08-30 |
| Find all providers in zip 46407 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396381760 | Sharnita L Rice | Nurse Practitioner | 2104 W 12th Ave, Gary, IN 46404-2375 | 2019-11-20 |
| 1912556507 | Tamera Beth Ball | Nurse Practitioner | 150 Venus Drive, Gary, WV 24836 | 2019-09-06 |
| 1689927691 | Monique Shantae Rash | Nurse Practitioner | Rr 103 Supply Strwet, Gary, WV 24836-0507 | 2012-10-16 |
| 1033302955 | Nicole Yvette Richards | Nurse Practitioner | 3900 Calhoun St, Gary, IN 46408-1753 | 2007-08-23 |
| 1285723445 | Sharon R Totten | Nurse Practitioner | 1145 W 5th Ave, Gary, IN 46402-1704 | 2006-10-12 |
| 1336236611 | Ruby J Bailey | Nurse Practitioner | 2269 West 25th Avenue, Gary, IN 46404-4509 | 2006-10-06 |
| 1013516939 | Laresse Harris | Nurse Practitioner | 1100 W 6th Ave, Gary, IN 46402-1711 | 2020-10-21 |
| 1437760519 | Bianca Yasmin Rafidia Vargas | Nurse Practitioner | 650 Grant St, Gary, IN 46404-1533 | 2020-08-12 |
| 1336761576 | Lakeysha Patrice Freeny | Nurse Practitioner | 650 Grant St Ste 7, Gary, IN 46404-1551 | 2020-05-11 |
| 1609427350 | Jessica Robin Marcus | Nurse Practitioner | Rr 103 Supply Street, Gary, WV 24836 | 2019-09-24 |
| Find all providers in GARY | ||||
Please comment or provide details below to improve the information on MRS. ILEANA GREEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.