Individual
MRS. EBONY P BELLE-JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
6307 FOX RIDGE DR, PLAINFIELD, IL 60586-5565
(708) 250-8799
Mailing address
6307 FOX RIDGE DR, PLAINFIELD, IL 60586-5565
(708) 250-8799
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209015184
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041391245
REGISTERED PROFESSIONAL NURSE
IL
Enumeration date
01/17/2017
Last updated
12/22/2021
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