Individual
DR. VERNELL JOHNSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 W COURT ST, KANKAKEE, IL 60901-3661
(815) 937-2100
Mailing address
555 W COURT ST, KANKAKEE, IL 60901-3675
(888) 828-3193
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4622394
BCBS
—
Enumeration date
06/20/2006
Last updated
12/06/2007
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