Individual
AMANDA JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
800 E CARPENTER ST, SPRINGFIELD, IL 62769-2021
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5101024264
MI
208600000X
Surgery Physician
5151011470
MI
2086S0102X
Surgical Critical Care Physician
Primary
036171086
IL
Other
Enumeration date
04/15/2008
Last updated
11/06/2024
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