Individual
DR. DERRICK JAMES JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
1022 MADISON, OAK PARK, IL 60302
(708) 802-1303
(708) 386-8602
Mailing address
1022 MADISON, OAK PARK, IL 60302
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
180004135
IL
103TC0700X
Clinical Psychologist
180004135
IL
Other
Enumeration date
02/09/2007
Last updated
11/22/2016
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