Individual
PATRICIA ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3062 E 91ST ST, CHICAGO, IL 60617-4401
(773) 371-2900
Mailing address
3062 E 91ST ST, CHICAGO, IL 60617-4401
(773) 371-2900
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
04/03/2019
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