Individual
DEBRA CHRISTINE FELDOTT-JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 MERCANTILE DR, HIGHLAND, IL 62249-1239
(618) 654-4449
(618) 654-3974
Mailing address
1250 MERCANTILE DR, HIGHLAND, IL 62249-1239
(618) 654-4449
(618) 654-3974
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036-101335
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101335
—
IL
Enumeration date
08/16/2005
Last updated
10/13/2011
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