Organization
ANNIE JOHN, M.D.S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNIE JOHN M.D. (PRESIDENT)
(773) 989-3977
Entity
Organization
Contact information
Practice address
3434 W PETERSON AVE, 1A, CHICAGO, IL 60659-3319
(773) 583-5803
Mailing address
P. O. BOX 2248, CAROL STREAM, IL 60132-2248
(847) 676-0091
(847) 676-2374
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
209-003580
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036-068169
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036068169
—
IL
Enumeration date
11/15/2005
Last updated
09/14/2009
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