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Individual

JEANNE M JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O

Contact information

Practice address
626 BETHANY RD, DEKALB, IL 60115-4939
(815) 756-1521
Mailing address
2807 BRITTANY CT, ST CHARLES, IL 60175-5161
(630) 377-8944

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036071485
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036071485
IL
01
099051
HEALTH ALLIANCE - KCH
IL
01
105167
HEALTH ALLIANCE - VWCH
IL
Enumeration date
01/23/2007
Last updated
11/20/2008
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