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Organization

DONNA L JOHNSON MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONNA JOHNSON MD (PHYSICIAN)
(773) 493-7041
Entity
Organization

Contact information

Practice address
7257 S JEFFERY BLVD, CHICAGO, IL 60649-3014
(773) 493-7040
(773) 493-8837
Mailing address
7257 S JEFFERY BLVD, CHICAGO, IL 60649-3014
(773) 493-7040
(773) 493-8837

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036055866
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036055856
IL
01
180030052
RAILROAD MEDICARE
IL
01
21608627
BCBS
IL
Enumeration date
12/06/2007
Last updated
03/28/2008
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