Green, Susan Diane

Green, Susan Diane is an sole proprietor health care provider with primary practice located at 307 E Court St , Jacksonville IL 62650-2019. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Prosthetics Case Management, Suppliers / Prosthetic/Orthotic Supplier. Suppliers / Prosthetic/Orthotic Supplier is her primary health care specialty. Green, Susan Diane can be contacted via phone (217) 370-7852.

Contact Information

Primary practice address
307 E Court St Jacksonville IL 62650-2019
Phone: (217) 370-7852
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Prosthetics Case Management 1744P3200X
Suppliers / Prosthetic/Orthotic Supplier 335E00000X

Profile Details

NPI number 1538843354
LBN Legal business name Green, Susan Diane
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 12th, 2023
Last updated Jun 20th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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