Individual
BEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
2003 W FULTON ST, CHICAGO, IL 60612-2345
(312) 850-3438
Mailing address
2003 W FULTON ST, CHICAGO, IL 60612-2345
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164006426
IL
Other
Enumeration date
03/14/2016
Last updated
03/14/2016
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