Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ottavia Kimberly Green, MD

Individual provider Anesthesiology Physician · NPI 1336701861

Ottavia Kimberly Green, MD is an Anesthesiology Physician in Park Ridge, Illinois. Works from 2 locations. Licensed in Illinois, Missouri and Texas.

Licensed in
IL, MO, TX
In the registry since
2019
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1775 Dempster St
Park Ridge, IL 60068-1143
Phone: (847) 723-2210
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 — (314) 362-1935

Specialties & licences

Anesthesiology Physician (primary) Taxonomy 207L00000X · Licence 036-170213 (IL)
Anesthesiology Physician Taxonomy 207L00000X · Licence 2019022382 (MO)
Anesthesiology Physician Taxonomy 207L00000X · Licence V0407 (TX)

Record details

NPI number1336701861
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 4, 2019
Last updated in NPPESFebruary 5, 2025
Certification dateFebruary 5, 2025

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