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Individual

MISS BREEA COREN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.D., L.D.N

Contact information

Practice address
2409 N CLYBOURN AVE, CHICAGO, IL 60614-6185
(773) 447-5269
(866) 611-5750
Mailing address
2409 N CLYBOURN AVE, CHICAGO, IL 60614-6185
(773) 447-5269
(866) 611-5750

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005123
IL

Other

Enumeration date
09/10/2009
Last updated
09/10/2009
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