Individual
MS. DANETTE E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5758 S MARYLAND AVE # 4A, CHICAGO, IL 60637-1426
(773) 702-1687
Mailing address
3961 E STATE ROUTE 17, KANKAKEE, IL 60901-8129
(773) 988-2816
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
05/25/2007
Last updated
07/08/2007
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