Individual
DONNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHLEBOTOMIST
Contact information
Practice address
10916 S SANGAMON ST, CHICAGO, IL 60643-3836
(800) 641-6130
Mailing address
10916 S SANGAMON ST, CHICAGO, IL 60643-3836
(800) 641-6130
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
D4B3A5A9
IL
247200000X
Other Technician
B8G9N5W2
IL
247200000X
Other Technician
Z6D2E9R4
IL
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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