Individual
JESSICA JOHNSON
Active
Individual
JESSICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036146931
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
04/08/2015
Last updated
11/27/2018
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