Provider Demographics
NPI:1639824584
Name:GREENE, CASSANDRA LYNN (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:LYNN
Last Name:GREENE
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:CASSANDRA
Other - Middle Name:
Other - Last Name:ELDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:251 E HURON ST FL 14
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2908
Mailing Address - Country:US
Mailing Address - Phone:312-926-9843
Mailing Address - Fax:312-926-8119
Practice Address - Street 1:251 E HURON ST FL 14
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2908
Practice Address - Country:US
Practice Address - Phone:312-926-9843
Practice Address - Fax:312-926-8119
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023212363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care