Individual
DANIEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1431 N WESTERN AVE STE 306, CHICAGO, IL 60622-1775
(708) 550-7201
Mailing address
1431 N WESTERN AVE, CHICAGO, IL 60622-1797
(708) 550-7201
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
178.019662
IL
Other
Enumeration date
07/20/2022
Last updated
12/19/2023
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