Provider Demographics
NPI:1083730733
Name:GREER, CHARLES E (DN)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:GREER
Suffix:
Gender:M
Credentials:DN
Other - Prefix:DR
Other - First Name:CHARLES
Other - Middle Name:ERNEST
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DN
Mailing Address - Street 1:1970 E 73RD ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60649-2902
Mailing Address - Country:US
Mailing Address - Phone:773-308-4412
Mailing Address - Fax:
Practice Address - Street 1:1970 E 73RD ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60649-2902
Practice Address - Country:US
Practice Address - Phone:773-308-4412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL181-000201174400000X, 172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath
No174400000XOther Service ProvidersSpecialist