Individual
MS. ANDRENE RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3224 S WESTERN AVE, PARK FOREST, IL 60466
(312) 259-4200
Mailing address
1803 W. 95TH ST., UNIT 196, CHICAGO, IL 60643-1103
(312) 259-4200
(773) 298-0673
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
05/15/2009
Last updated
05/15/2009
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