Individual
MS. MARY CHRISTINE JOHANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
4309 W MEDICAL CENTER DR STE A200, MCHENRY, IL 60050-8437
(815) 759-8070
(815) 759-4931
Mailing address
4309 W MEDICAL CENTER DR STE A200, MCHENRY, IL 60050-8437
(815) 759-8070
(815) 759-4931
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209020914
IL
363LA2200X
Adult Health Nurse Practitioner
209020614
IL
363LF0000X
Family Nurse Practitioner
209.020914
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209020914
—
IL
Enumeration date
02/25/2020
Last updated
02/17/2026
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