Individual
DR. THEODORE LAWRENCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
200 E ROOSEVELT RD, LOMBARD, IL 60148-4539
(630) 889-6513
(630) 889-6800
Mailing address
200 E ROOSEVELT RD, LOMBARD, IL 60148-4539
(630) 889-6513
(630) 889-6800
Taxonomy
Speciality
Code
Description
License number
State
111NI0900X
Internist Chiropractor
Primary
0038006656
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0038006656
PROFESSIONAL LICENCE NUMB
IL
Enumeration date
01/04/2006
Last updated
04/29/2016
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