Individual
PATRICK RYAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5841 S MARYLAND AVE # MC6065, CHICAGO, IL 60637-1443
(773) 702-9775
Mailing address
1415 N WICKER PARK AVE APT 3, CHICAGO, IL 60622-1930
(608) 692-8400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.008326
IL
Other
Enumeration date
11/03/2021
Last updated
11/16/2021
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