Individual
KELLY MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
40 SKOKIE BLVD, NORTHBROOK, IL 60062-1601
(847) 291-3999
Mailing address
40 SKOKIE BLVD STE 550, NORTHBROOK, IL 60062-1617
(312) 440-3810
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209.017943
IL
Other
Enumeration date
08/31/2018
Last updated
02/22/2024
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