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Individual

WANNAKEE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8211 S DAMEN AVE, CHICAGO, IL 60620-5335
(312) 221-6841
Mailing address
8211 S DAMEN AVE, CHICAGO, IL 60620-5335
(312) 221-6841

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
J52588065630
IL

Other

Enumeration date
08/29/2025
Last updated
08/29/2025
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