Individual
KRISTER M JOHANSSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5215 N CALIFORNIA AVE, SUITE 604, CHICAGO, IL 60625-7014
(773) 878-3627
(773) 293-8824
Mailing address
5215 N CALIFORNIA AVE, SUITE 604, CHICAGO, IL 60625-7014
(773) 878-3627
(773) 293-8824
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036101307
IL
207Q00000X
Family Medicine Physician
Primary
036101307
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101307
—
IL
Enumeration date
05/31/2006
Last updated
04/12/2021
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