Individual
ELLIOT PAUL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2900 FOXFIELD RD, SUITE 102, ST CHARLES, IL 60174-5799
(630) 377-1188
(630) 377-7360
Mailing address
2900 FOXFIELD RD, SUITE 102, ST CHARLES, IL 60174-5799
(630) 377-1188
(630) 377-7360
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
085005130
IL
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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