Individual
JESSICA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
1014 LOWDEN RD, STREATOR, IL 61364-1418
(815) 674-0980
Mailing address
1014 LOWDEN RD, STREATOR, IL 61364-1418
(815) 674-0980
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO 3668
FL
Other
Enumeration date
05/02/2011
Last updated
08/07/2014
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