Provider Demographics
NPI:1457348682
Name:GREENE, CECILIA S (MSW)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:S
Last Name:GREENE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 N MICHIGAN AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60601-5311
Mailing Address - Country:US
Mailing Address - Phone:312-621-9166
Mailing Address - Fax:312-880-0098
Practice Address - Street 1:307 N MICHIGAN AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5311
Practice Address - Country:US
Practice Address - Phone:312-621-9166
Practice Address - Fax:312-880-0098
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149-0013531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical