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Individual

MRS. MAI-PHUONG JOHNSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
3012 W FULLERTON AVE, #4, CHICAGO, IL 60647-2808
(773) 276-5212
Mailing address
3012 W FULLERTON AVE, #4, CHICAGO, IL 60647-2808
(773) 276-5212

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
IL

Other

Enumeration date
03/20/2008
Last updated
03/20/2008
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