Provider Demographics
NPI:1922548023
Name:GREER, LUELLA
Entity Type:Individual
Prefix:
First Name:LUELLA
Middle Name:
Last Name:GREER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LUELLA
Other - Middle Name:
Other - Last Name:MOSLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1001 N LAMON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60651-3137
Mailing Address - Country:US
Mailing Address - Phone:773-664-7520
Mailing Address - Fax:
Practice Address - Street 1:1001 N LAMON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60651-3137
Practice Address - Country:US
Practice Address - Phone:773-664-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILNA436376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide