Individual
JESSE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3319 N ELSTON AVE, CHICAGO, IL 60618-5811
(312) 773-0883
Mailing address
3319 N ELSTON AVE, CHICAGO, IL 60618-5811
(312) 773-0883
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
IL
Other
Enumeration date
04/24/2023
Last updated
04/24/2023
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