Individual
SHERETTA THERESE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1900 W POLK ST, CHICAGO, IL 60612-3723
(312) 771-3412
Mailing address
1900 W POLK ST, CHICAGO, IL 60612-3723
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
041-313270
IL
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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