Individual
ROTIMI JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2385 BOWES RD STE 350, ELGIN, IL 60123-5501
(847) 429-2091
(847) 429-2440
Mailing address
PO BOX 3242, INDIANAPOLIS, IN 46206-3242
(317) 705-6708
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
036123822
IL
2085R0202X
Diagnostic Radiology Physician
2012013474
MO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036123822
IL
2085R0204X
Vascular & Interventional Radiology Physician
2012013474
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036123833
MEDICAL LICENSE
IL
01
—
2012013474
STATE LICENSE
MO
Enumeration date
09/13/2010
Last updated
12/26/2022
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