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Organization

LAWRENCE L. JOHNSON, M.D., S.C.

Active
Other names
Lawrence L. Johnson, M.D., S.C.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAWRENCE L. JOHNSON M.D. (OWNER)
(630) 232-2885
Entity
Organization

Contact information

Practice address
351 DELNOR DR, STE. 400, GENEVA, IL 60134
(630) 232-2885
(630) 232-9936
Mailing address
351 DELNOR DR, STE. 400, GENEVA, IL 60134
(630) 232-2885
(630) 232-9936

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036052717
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036052717
IL
01
4500588
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/30/2006
Last updated
02/24/2015
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