Individual
DR. JORDAN ALICIA JOHNSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO, MS
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-5580
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-1921
(860) 679-2147
(860) 679-4624
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
67892
CT
2080P0202X
Pediatric Cardiology Physician
67892
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2019
Last updated
04/01/2024
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