IndividualActive
Kenneth Green, M.D,
NPI 1780680900 · Ophthalmology Physician · Belleville, IL
Provider details
- NPI number
- 1780680900
- Entity type
- Individual
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D,
- Sex
- Male
- Sole proprietor
- No
- License
- 036037266 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
111 W Lincoln St
Belleville, IL 62220-2019
Phone: (618) 234-1774
Fax: (618) 234-7979
Approximate (ZIP-level) locationGet directions
Mailing address
111 W Lincoln St
Belleville, IL 62220-2019
Registry dates
- Enumerated
- 2005-06-22
- Last updated
- 2009-04-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.