Individual
CHRISTOPHER REAVIS JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 W JACKSON ST, MORTON, IL 61550-1535
(309) 938-4067
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-131984
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036131984
—
IL
Enumeration date
05/22/2009
Last updated
12/19/2024
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