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Organization
SOUTHSIDE ASSISTANTS, INC.
Active
Organization
SOUTHSIDE ASSISTANTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN JOHNSON FNP-C, MSN (FAMILY NURSE PRACTITIONER)
(708) 256-0816
Entity
Organization
Contact information
Practice address
21200 S LAGRANGE RD, SUITE 134, FRANKFORT, IL 60423-2003
(708) 256-0816
(815) 534-5576
Mailing address
21200 S LAGRANGE RD, SUITE 134, FRANKFORT, IL 60423-2003
(708) 256-0816
(815) 534-5576
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209009090
IL
Other
Enumeration date
05/08/2007
Last updated
10/11/2011
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