Individual
MS. LAUREN K JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, PCS
Contact information
Practice address
1010 N HOOKER ST, SUITE 301, CHICAGO, IL 60642-4549
(312) 943-3600
(312) 943-3096
Mailing address
1164 CLINTON AVE, OAK PARK, IL 60304-1846
(314) 704-4315
(708) 680-0126
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
070.020630
IL
2251P0200X
Pediatric Physical Therapist
Primary
070020630
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0403
PHYSICAL THERAPY LICENSE
ME
Enumeration date
04/14/2006
Last updated
03/17/2018
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