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Individual

MR. JOHNNY B TERRY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT

Contact information

Practice address
25 N WINFIELD RD STE 201, WINFIELD, IL 60190-1379
(630) 933-4480
Mailing address
25 N WINFIELD RD STE 201, WINFIELD, IL 60190-1379
(630) 933-4480

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006972
IL
363AS0400X
Surgical Physician Assistant
PA9106081
FL
363AS0400X
Surgical Physician Assistant
GA

Other

Enumeration date
12/02/2009
Last updated
04/04/2025
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