Individual
DR. PATRICIA A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
509 W UNIVERSITY AVE, URBANA, IL 61801-2530
(217) 383-6636
(217) 383-3466
Mailing address
611 W. PARK ST., BWPC, URBANA, IL 61801-2500
(217) 383-6792
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
036056893
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
130007393
RAILROAD PIN
IL
Enumeration date
07/13/2006
Last updated
05/26/2015
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