# DAVID P JOHNSON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Johnson Portable Xray Service
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801842968
- **Authorized official:** MR. DAVID P JOHNSON R.T.R. (OWNER OPERATOR)
- **Authorized official phone:** (815) 544-7120

## Contact information

- **Practice address:** 8198 COMMERCE DR STE A, LOVES PARK, IL 61111-5710
- **Practice address phone:** (815) 544-7120
- **Practice address fax:** (815) 885-4271
- **Mailing address:** 8198 COMMERCE DR STE A, LOVES PARK, IL 61111-5710
- **Mailing address phone:** (815) 544-7120
- **Mailing address fax:** (815) 885-4271

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335V00000X | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 500498218 | IL | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 07/21/2022