Organization
JOHNSON CHIROPRACTIC CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY W. JOHNSON D.C. (PRESIDENT)
(309) 852-2885
Entity
Organization
Contact information
Practice address
109 S BURR BLVD, KEWANEE, IL 61443-2219
(309) 852-2885
(309) 854-6410
Mailing address
109 S BURR BLVD, KEWANEE, IL 61443-2219
(309) 852-2885
(309) 854-6410
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038004465
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3715466
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/02/2007
Last updated
09/23/2024
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