Individual
THEODORE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3410 ILLINOIS ST, GREAT LAKES, IL 60088-3120
(224) 610-8553
Mailing address
220 HOVEY RD, PENSACOLA, FL 32508-1044
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
0101279593
VA
208D00000X
General Practice Physician
Primary
0101279593
VA
Other
Enumeration date
03/03/2022
Last updated
07/09/2025
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us