Individual
MS. ALICIA ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
121 FAIRFIELD WAY STE 207, STE 207, BLOOMINGDALE, IL 60108-1559
(630) 529-7427
(630) 529-9937
Mailing address
7854 S STH SHR DR APT 508, CHICAGO, IL 60649-5374
(312) 498-6834
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102729
NC
Other
Enumeration date
05/17/2006
Last updated
05/09/2016
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