Individual
MR. TIMOTHY JOHNSON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
(708) 326-1550
Mailing address
16170 KINGSPORT RD, ORLAND PARK, IL 60467-5602
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004245
IL
Other
Enumeration date
06/05/2015
Last updated
06/05/2015
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