Individual
KAROLYN GAYLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1745 W 102ND ST, CHICAGO, IL 60643-2146
(360) 798-8738
Mailing address
1745 W 102ND ST, CHICAGO, IL 60643-2146
(360) 798-8738
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.461899
IL
363LF0000X
Family Nurse Practitioner
Primary
209.017686
IL
Other
Enumeration date
05/29/2018
Last updated
09/05/2024
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