Individual
GREGORY L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
900 MAIN ST, SUITE 100, PEORIA, IL 61602-1005
(309) 672-4908
(309) 672-4272
Mailing address
900 MAIN ST, SUITE 100, PEORIA, IL 61602-1005
(309) 672-4908
(309) 672-4272
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
036115494
IL
Other
Enumeration date
02/21/2006
Last updated
01/31/2013
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