Individual
YOLANDRA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
510 GREEN BAY RD, KENILWORTH, IL 60043-1002
(847) 251-8661
(847) 256-3412
Mailing address
510 GREEN BAY RD, KENILWORTH, IL 60043-1002
(847) 251-8661
(847) 256-3412
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036086910
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036086910
BLUE CROSS
IL
01
—
110152884
RAILROAD MEDICARE
IL
Enumeration date
08/16/2005
Last updated
05/31/2013
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