Individual
PATRICE TAMILAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10755 S LOWE AVE, CHICAGO, IL 60628-3109
(312) 623-1260
Mailing address
10755 S LOWE AVE, CHICAGO, IL 60628-3109
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209-008251
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209008251041342524
IL
Other
Enumeration date
08/01/2010
Last updated
04/02/2026
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