Individual
LUIZA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
21481 N RAND RD, KILDEER, IL 60047-3061
(847) 618-9696
(847) 618-9695
Mailing address
21481 N RAND RD, KILDEER, IL 60047-3061
(847) 618-9696
(847) 618-9695
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036163607
IL
207Q00000X
Family Medicine Physician
86470
GA
Other
Enumeration date
06/02/2018
Last updated
04/11/2023
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