Individual
DR. GERALD TIMOTHY JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5101 WILLOW SPRINGS RD, LA GRANGE, IL 60525-2600
(708) 352-1200
Mailing address
352 GLENWOOD DR APT 303, BLOOMINGDALE, IL 60108-3253
(630) 307-6937
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
IL
Other
Enumeration date
07/25/2006
Last updated
07/08/2007
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