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Individual

DR. JOHNSON MAO

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2506 N CLARK ST, #282, CHICAGO, IL 60614-1848
(312) 842-8210
(312) 842-8281
Mailing address
2600 S MICHIGAN AVE, #403, CHICAGO, IL 60616-2857

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36050106
IL

Other

Enumeration date
06/03/2006
Last updated
07/08/2007
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