Individual
ANASTASIA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
11305 W LINCOLN HWY, MOKENA, IL 60448-2070
(815) 277-0510
Mailing address
16359 STONEY BROOK DR, LEMONT, IL 60439-4775
(708) 518-5064
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051299427
IL
Other
Enumeration date
01/17/2019
Last updated
01/17/2019
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