Individual
MARYANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
7115 NORTH AVE # 115, OAK PARK, IL 60302-1002
(708) 299-7411
Mailing address
7115 NORTH AVE # 115, OAK PARK, IL 60302-1002
(708) 299-7411
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041305291
IL
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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