Individual
KAYLA JEAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
190 S PROSPECT AVE, ELMHURST, IL 60126-3271
(630) 617-3400
Mailing address
4547 N KARLOV AVE, CHICAGO, IL 60630-4401
(773) 791-9708
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096005287
IL
Other
Enumeration date
03/31/2021
Last updated
02/01/2023
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