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Individual

DIANE L JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
3703 W LAKE AVE STE 200, GLENVIEW, IL 60026-1266
(847) 998-1188
Mailing address
6506 LANGSFORD LN, PLAINFIELD, IL 60586-7209

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
160.001865
IL

Other

Enumeration date
04/28/2008
Last updated
04/28/2008
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