Individual
SIOBHAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
50 E 16TH ST UNIT 412, CHICAGO, IL 60616-5137
(708) 207-7524
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041331553
IL
363LA2100X
Acute Care Nurse Practitioner
Primary
209010895
IL
Other
Enumeration date
08/26/2013
Last updated
06/29/2021
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