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Individual

MS. TIKINA L JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9051 S JUSTINE ST, CHICAGO, IL 60620-5034
(312) 536-3425
Mailing address
9051 S JUSTINE ST, CHICAGO, IL 60620-5034
(312) 536-3425

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043116735
IL

Other

Enumeration date
01/20/2021
Last updated
01/20/2021
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