Individual
DR. TODD ANDREW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1765 N ELSTON AVE, SUITE 110, CHICAGO, IL 60642-1501
(773) 276-1100
(773) 276-1102
Mailing address
1765 N ELSTON AVE, SUITE 110, CHICAGO, IL 60642-1501
(773) 276-1100
(773) 276-1102
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036110291
IL
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
036110291
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036110291
—
IL
Enumeration date
10/12/2006
Last updated
11/03/2015
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