Individual
COLEEN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1501 S CALIFORNIA AVE, DEPARTMENT OF FAMILY MEDICINE L1026, CHICAGO, IL 60608-1732
(708) 406-5929
Mailing address
1501 S CALIFORNIA AVE, DEPARTMENT OF FAMILY MEDICINE L1026, CHICAGO, IL 60608-1732
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
125066897
IL
Other
Enumeration date
07/15/2015
Last updated
11/19/2021
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