Individual
ANDRE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(312) 413-2769
Mailing address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
149.018574
IL
Other
Enumeration date
08/12/2016
Last updated
08/12/2016
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