Organization
NORTH CHICAGO WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE JOHNSON PSYD (LICENSED CLINICAL PSYCHOLOGIST)
(773) 655-5329
Entity
Organization
Contact information
Practice address
3708 N ASHLAND AVE # G, CHICAGO, IL 60613-5272
(773) 655-5329
Mailing address
3708 N ASHLAND AVE # G, CHICAGO, IL 60613-5272
(773) 655-5329
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071008143
IL
Other
Enumeration date
12/04/2017
Last updated
12/04/2017
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