Individual
LINDA INEZ JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6415 STANLEY AVE, BERWYN, IL 60402-3130
(708) 995-3559
Mailing address
4705 S CHAMPLAIN AVE APT 201, CHICAGO, IL 60615-1586
(773) 418-2447
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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