Individual
JEFFREY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7425 JANES AVE, WOODRIDGE, IL 60517-2356
(708) 550-7005
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 304-8476
(425) 304-8477
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61271444
WA
363AM0700X
Medical Physician Assistant
085.005650
IL
Other
Enumeration date
11/16/2015
Last updated
04/03/2025
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