Organization
PETER E JOHNSON MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER E JOHNSON MD (PRESIDENT)
(847) 296-5470
Entity
Organization
Contact information
Practice address
8901 W GOLF RD, #204, DES PLAINES, IL 60016
(847) 296-5470
(847) 296-5474
Mailing address
8901 W GOLF RD, #204, DES PLAINES, IL 60016
(847) 296-5470
(847) 296-5474
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1630266
BCBS PROVIDER ID
IL
01
—
2487670
AETNA PROVIDER #
IL
01
—
4138183004
CIGNA PROVIDER #
IL
Enumeration date
04/26/2006
Last updated
09/06/2007
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