Organization
JADA J JOHNSON MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELA J RATCLIFFE (CHIEF OPERATIONS OFFICER)
(773) 995-9600
Entity
Organization
Contact information
Practice address
11451 S MICHIGAN AVE, CHICAGO, IL 60628-4901
(773) 995-9600
(773) 995-9601
Mailing address
11451 S MICHIGAN AVE, CHICAGO, IL 60628-4901
(773) 995-9600
(773) 995-9601
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
036123239
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123239
—
IL
Enumeration date
06/11/2011
Last updated
06/11/2011
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