Individual
MS. JILL LYNNE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
305 JOE DR E, AMBOY, IL 61310-9492
(815) 857-2458
(815) 857-2749
Mailing address
PO BOX 145, AMBOY, IL 61310-0145
(815) 857-2458
(815) 857-2749
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227.002367
IL
Other
Enumeration date
01/16/2009
Last updated
01/16/2009
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