MCKENZIE DICKSON GREENE PA NPI 1154881837

NPI Information

NPI: 1154881837
Provider Name: MCKENZIE DICKSON GREENE, PA
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
2850 S WABASH AVE STE 100
CHICAGO, IL
ZIP 60616
Phone: (312) 842-4600
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Mckenzie Dickson Greene, PA is a surgical physician assistant in Chicago, IL with 6 years of experience. Mckenzie Dickson Greene, PA NPI is 1154881837. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2850 S WABASH AVE STE 100
CHICAGO, IL
ZIP 60616-491
Phone: (312) 842-4600
Fax: (312) 842-8690

The NPI 1154881837 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/20/2019 and was last updated on 3/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		085006947	ILLINOIS	No
2	363AM0700X	Physician Assistant	Medical	085006947	ILLINOIS	No
3	363AS0400X	Physician Assistant	Surgical	085006947	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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