Individual
LISA S JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
510 EXETER PL, LAKE FOREST, IL 60045-1521
(847) 373-8052
Mailing address
510 EXETER PL, LAKE FOREST, IL 60045-1521
(847) 373-8052
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/04/2020
Last updated
02/04/2020
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