Individual
MRS. LISA ANNETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, DNP
Contact information
Practice address
4755 N KENMORE AVE, CHICAGO, IL 60640-5015
(773) 989-9868
Mailing address
14313 S PARNELL AVE, RIVERDALE, IL 60827-2316
(773) 676-6059
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209013768
IL
Other
Enumeration date
03/09/2016
Last updated
11/08/2021
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