JEFFREY RORDAN CILLIAN GREEN
NPI 1659087815
Counselor in Chicago, IL

Q: What is Jeffrey Rordan Green's NPI number?

The NPI number for Jeffrey Rordan Green is 1659087815. It was assigned to this individual provider in the NPPES registry on January 30, 2023.

Q: What is Jeffrey Rordan Green's specialty?

The primary specialty registered for this NPI is Counselor with taxonomy code 101Y00000X.

Active since January 30, 2023PECOS Enrolled

4711 N BROADWAY ST STE 102, CHICAGO, IL 60640(630) 523-3177 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jeffrey Rordan Cillian Green NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY RORDAN CILLIAN GREEN (NPI 1659087815) is an individual counselor in Chicago, Illinois, licensed in Illinois (178.018777) and active in the NPI registry since January 2023. He is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1659087815

Entity TypeIndividualMale

Primary Taxonomy101Y00000X

Provider Legal NameJEFFREY RORDAN CILLIAN GREEN

Location Address4711 N BROADWAY ST STE 102Chicago, IL 60640-4908

Mailing Address4711 N Broadway St Ste 102Chicago, IL 60640-4908

Phone(630) 523-3177

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateJanuary 30, 2023

NPPES CertifiedJanuary 30, 2023

✔ NPI 1659087815 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselorBehavioral Health & Social Service Providers

Taxonomy Code101Y00000X

License✔ Licensed in IL · 178.018777

Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

4711 N BROADWAY ST STE 102, Chicago, IL 60640

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey Rordan Cillian Green is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8527549005

PECOS Enrollment IDI20260223002759

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRACTICAL MAGIC HEALING

Social Worker (Clinical)