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Individual

ANTOINETTE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
HIGH SCHOOL DIPLOMA

Contact information

Practice address
3494 FAIRWAY DR, CRETE, IL 60417-1000
(773) 557-5931
Mailing address
3494 FAIRWAY DR, CRETE, IL 60417-1000
(773) 557-5931

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary

Other

Enumeration date
01/14/2022
Last updated
01/14/2022
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