Individual
CHARISSE LESHON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
119 E 120TH ST, CHICAGO, IL 60628-6250
(773) 568-7557
Mailing address
119 E 120TH ST, CHICAGO, IL 60628-6250
(773) 568-7557
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
51286810
IL
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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