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Individual

NIKKITA CHENNILLE JOHNSON-NEEALY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1109 E 156TH ST, DOLTON, IL 60419-2777
(773) 454-8514
(708) 841-2070
Mailing address
1458 W 123RD ST, CHICAGO, IL 60643-5768
(773) 454-8514
(708) 598-3796

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.087417
IL

Other

Enumeration date
06/26/2007
Last updated
07/08/2007
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